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J Hand Microsurg 2018; 10(02): 86-92
DOI: 10.1055/s-0038-1636728
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Soft Tissue Sarcoma of the Hand and Wrist: Epidemiology and Management Challenges

S. Nicholson
1   Department of Plastic Surgery, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom
,
R. H. Milner
1   Department of Plastic Surgery, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom
,
M. Ragbir
1   Department of Plastic Surgery, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom
› Author Affiliations Funding None.
Further Information

Publication History

Received: 17 April 2017

Accepted: 20 January 2018

Publication Date:
03 April 2018 (online)

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Abstract

Soft tissue sarcomas (STSs) of the hand and wrist are rare and confer a unique set of management challenges. We present a 15-year review and discussion of the epidemiology, tumor characteristics, treatment, and reconstructive strategies for such cases presenting to our regional sarcoma service. Three case examples are described. Of 218 STSs of the upper limb, 17 involved the hand or wrist. Alveolar rhabdomyosarcoma, synovial, and myxofibrosarcoma were the most common ones. Two patients required amputation for recurrence. Eight patients required flap reconstruction, of which five were free flaps with no failures or wound healing complications. Two-year overall survival rate was 92%. Local recurrence occurred in 12%. Limb-sparing surgery is possible in most patients, although there is often a degree of functional loss due to the surgical resection, and complex multistage reconstruction may be required. These lesions are still often incidental or unexpected findings when patients are treated for a presumed benign swelling. Clinicians treating localized swellings of the hand and wrist should maintain vigilance toward the possibility of a sarcoma diagnosis, to avoid delays in definitive treatment.

Keywords

soft tissue - sarcoma - hand - wrist - outcomes - management
 

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