Surgical Options for Malignant Skin Tumors of the Hand.
10.5999/aps.2013.40.3.238
- Author:
Min Ji YUN
1
;
Ji Ung PARK
;
Sung Tack KWON
Author Information
1. Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea. stk59@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Skin neoplasms;
Melanoma;
Carcinoma, squamous cell;
Surgical flaps
- MeSH:
Amputation;
Carcinoma, Squamous Cell;
Fingers;
Follow-Up Studies;
Hand;
Humans;
Incidence;
Medical Records;
Melanoma;
Neoplasm Metastasis;
Recurrence;
Retrospective Studies;
Sarcoma;
Skin;
Skin Neoplasms;
Surgical Flaps;
Survival Rate
- From:Archives of Plastic Surgery
2013;40(3):238-243
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Primary malignant tumors of the hand, although unusual, may present varied and often complex clinical problems. The main treatment modality of skin cancer of the hand has changed. METHODS: We retrospectively reviewed the medical records of 43 patients who underwent surgery for malignant skin tumors of the hand during an 18-year period, from September 1994 to February 2012. The characteristics of the tumor, methods of reconstruction, and long-term results were reviewed. RESULTS: We had 43 patients with 27 melanomas, 14 squamous cell carcinomas, and 2 sarcomas. Their ages ranged from 19 to 74 years (mean, 53.4+/-14.5 years), from 46 to 79 years (mean, 59.7+/-9.6 years), and from 15 to 43 years (mean, 29+/-19.8 years), respectively. Thirty-four cases occurred on the fingertip (16 of those cases on the thumb), 5 cases occurred on the palm, and 4 cases on the dorsum of the hand. Amputation was most frequently used in early cases, but recently, tissue-sparing excision has been performed frequently. The incidence of local recurrence was 3 cases and distant metastasis was 1 case, and the 5-year survival rate was 100%, except in 4 cases due to follow-up loss. CONCLUSIONS: The principles of treatment-to be curative and to preserve function and appearance-are important points. "Preservative surgery" preserves function and cosmesis of the involved finger or hand dorsum or palm. Preservative surgery not only emphasizes less resection and surgery of a smaller scale, but also optimal reconstruction of the soft tissue defect of the digit.
