Elsevier

The Journal of Hand Surgery

Volume 26, Issue 6, November 2001, Pages 1151-1156
The Journal of Hand Surgery

Original Communications
Primary osteogenic sarcoma of a finger proximal phalanx: A case report and literature review,☆☆

https://doi.org/10.1053/jhsu.2001.28945Get rights and content

Abstract

Osteogenic sarcoma of the small bones of the hand is rare with only 15 cases documented. We describe a 12-year-old boy with an osteogenic sarcoma of the proximal phalanx of the middle finger. Wide excision in the form of ray amputation with a wide surgical margin was performed after neoadjuvant chemotherapy consisting of combined high-dose methotrexate, doxorubicin, ifosfamide, and cisplatin. To restore maximum function the index ray was transferred to the base of the third metacarpal. Adjuvant chemotherapy was administered subsequently. At 28-month follow-up evaluation there was no evidence of local recurrence of disease or distant metastasis and both function and appearance were good. (J Hand Surg 2001;26A: 1151-1156. Copyright © 2001 by the American Society for Surgery of the Hand.)

Section snippets

Case report

A 12-year-old boy presented with painful swelling in the proximal phalanx of the left middle finger of 1 month's duration. He had no remarkable medical or family history.

Examination revealed tender swelling of the radial side of the middle finger at the level of the proximal phalanx. Range of motion testing of the middle finger metacarpophalangeal joint elicited pain (Fig. 1).

. The patient's left hand has remarkable swelling on the radial side of the proximal phalanx of the middle finger.

Discussion

Osteogenic sarcoma in the small tubular bones of the hands is uncommon, constituting only 0.1% to 0.2% of all cases.14, 15 We have identified 36 cases of this tumor type, excluding extraskeletal cases, in the hand in an extensive literature search, 15 of which involved phalanges. In the previously reported cases of osteogenic sarcomas in the phalanges, the mean age was 49 years (range, 16–81 years) and the incidence of secondary cases was high: 6 of 15 were secondary and 9 of 15 were primary

Acknowledgements

The authors thank Yoshio Mii, MD, for advice on the histologic findings; Toru Morishita, MD, Kazuhisa Kizaki, MD, Toru Yamauchi, MD, Nana Kuramoto, MD, and Shinji Isomoto, MD, for assistance; and Malcolm Moore, PhD, for linguistic advice.

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    ☆☆

    Reprint requests: Kanya Honoki, MD, Department of Orthopedic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.

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