Tumors of the Hand

Abstract

Because the hand, like the face, is the first encounter of a patient by any clinician, a basic knowledge of hand tumours is relevant to all clinical practice. Tumours can arise from any of the six main tissues of the hand. Most tumours of the hand are not true neoplasms but the result of classic disease states—trauma, infection, inflammatory disease, metabolic disorder, degenerative disorder, congenital anomaly. The clinician then needs to know which tumours should be investigated and referred on to a specialist. Egloff's book, published in association with the Federation of Societies for Surgery of the Hand, provides a near-comprehensive review. Tumours of the hand and upper extremity were the subject of an issue of Hand Clinics this year (2004; 20: No. 2) but no book has been devoted solely to the subject since the 1988 Tumours of the Hand by Glicenstein, Ohana and Leclercq (Springer Verlag). Two omissions are noteworthy. First, 90% of hand tumours are ganglia, and Egloff and his team decided to exclude these because they are not true tumours and their treatment is to be found in all textbooks. In our opinion, ganglia deserved a place because they come into the different diagnosis of tumours; a ganglion can be hard to distinguish from a giant cell tumour of tendon sheath, which is the second commonest tumour. Second, skin tumours, except for melanomas, are excluded. Otherwise the book offers comprehensive coverage of tumours both benign and malignant, with important and useful information on clinical and radiological diagnosis (including ultrasound and MRI). Advances in MRI have helped not only in diagnosis but also in follow-up to detect recurrences and extensions. For malignant tumours the authors emphasize the need for investigation and treatment in specialist centres where hand surgeons, pathologists, oncologists and radiologists work as a team. Peripheral nerve sheath tumours and vascular tumours, which can be difficult to diagnose and manage, are well discussed, and an excellent section on soft tissue tumours ends with a chapter describing the 25-year experience of the Cooperative Osteosarcoma Study Group. All the chapters are well referenced. Many kinds of surgeon—general, orthopaedic, plastic, neuro—will value the advice provided here on diagnosis and management. Trainee and specialist hand surgeons will find it particularly useful.