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Background: A synovial cyst is a herniation of synovial tissue through a joint capsule, often mistaken for a ganglion cyst. The key distinctions are that synovial cysts have a synovial cell lining, while a ganglion cyst is delineated by dense fibrous connective tissue. Typically found near joints, synovial cysts are associated with conditions like osteoarthritis, prevalent in females aged 20 to 50. We present a rare case of a synovial cyst in the extensor digitorum superficialis of the right hand. Case summary: A 53-year-old Hispanic female visited our hand clinic due to a 3-year history of pain on the back of her right hand. At exploration, a 3 × 3 cm soft tumor was identified. Surgery revealed a clear-yellowish mass within the extensor digitorum superficialis tendon. Following the surgery, synovial cyst was confirmed by pathology and the patient was discharged without complications. Conclusion: This case highlights the rare presentation of an intratendinous synovial cyst and emphasizes the importance of a comprehensive understanding of synovial cysts in the differential diagnosis of hand tumors.

Background Giant cell tumors of the tendon sheath (GCTTS) of the hand are considered the second most common benign tumors of the hand after ganglion cysts. Excision biopsy is considered the standard treatment at present. They are notorious for having a very high rate of recurrence as given in many studies. Many factors are said to be associated with recurrence of the tumors. The goal of this study is to evaluate the long-term results of a series of 48 patients operated on at a single institute and to find out if there is any correlation between the proposed risk factors with recurrence.

Background Giant cell tumors of the tendon sheath (GCTTS) of the hand are considered the second most common benign tumors of the hand after ganglion cysts. Excision biopsy is considered the standard treatment at present. They are notorious for having a very high rate of recurrence as given in many studies. Many factors are said to be associated with recurrence of the tumors. The goal of this study is to evaluate the long-term results of a series of 48 patients operated on at a single institute and to find out if there is any correlation between the proposed risk factors with recurrence. Methods A retrospective analysis was done in cases of GCTTS operated on between 2015 and 2021. The patients were invited for follow-up for a minimum of 2 years, and the patient files were reviewed. Further data were collected at follow-up including recurrence, range of movement, sensation, skin necrosis, scarring, and digital neuropathy. A data analysis was done. The correlation between the proposed risk factors and recurrence was calculated with the Pearson correlation coefficient. A p -value of less than 0.05 was considered statistically significant. Results During the 6 years, 48 patients were operated on. Recurrence was observed in eight patients (16%) at an average of 38.7 months from the time of surgery. Of the risk factors, tumors with satellite nodules and tumor adjacency to joint correlated significantly with recurrence. No complications were observed during follow-up. Conclusion GCTTS of the hand has a high propensity to recur. The presence of satellite nodules and proximity to interphalangeal joints are two important risk factors for recurrence. Magnification during surgery ensures complete excision of the tumor and reduces the chance of recurrence. [ABSTRACT FROM AUTHOR]

Se presenta un caso de fibroma de la vaina tendinosa, tumor benigno poco frecuente de adultos de 20–40 años y de extraordinaria rareza en la edad infantil, localizado en la cara palmar de la falange media del tercer dedo de la mano derecha de una niña de 6 años. El diagnóstico se efectuó tras su exéresis mediante el estudio histológico de la lesión, pues los estudios de imagen previos mediante ecografía y resonancia magnética no fueron concluyentes. A pesar de que la resección quirúrgica constituye el tratamiento de elección, existe un alto riesgo de recidiva de la enfermedad.

Angiolipoma, a subtype of lipoma, is a benign adypocytic soft tissue tumor composed of mature adipose tissue and small vascular proliferations. This entity makes up 5–17% of all lipomas. The diagnosis is made by clinical and pathological examination, ultrasonography, and/or magnetic resonance imaging (MRI). It is generally an encapsulated tumor (noninfiltrative), but rarely has an infiltrative form. Angiolipoma mostly occurs on the trunk and extremities with male predominance. The forearm is the most frequent location for angiolipomas. It is very rarely seen on the fingers. Herein, we report a patient with solitary noninfiltrating angiolipoma on a finger. The patient was treated with surgical excision and no recurrence has been noted over one year of observation.

Purpose: The goal of the study was to assess the result of en bloc resection and matched nonvascularized toe phalangeal transfer in Campanacci grade 2 or 3 giant cell tumors of the phalanges., Methods: Seven patients with Campanacci grade 2 and 3 phalangeal giant cell tumors were treated by en bloc resection and matched nonvascularized toe phalangeal transfer between June 2004 and May 2021. The patients were followed up by X-rays, Patient-Rated Hand and Wrist scores, Foot Function Index, Quick Disabilities of the Arm, Shoulder, and Hand questionnaire, and total active motion measurements., Results: The minimum follow-up was 18 months (range: 18-230 months; mean: 110 ± 81). There were three males and four females, with age ranging from 13 to 48 years (mean: 24.14 ± 11.74). The right:left hand ratio was 3:4. The thumb was involved in one patient, the index finger in two, the middle finger in one, and the ring finger in three patients. The mean total active motion was 201.70 (range: 190°-240°). The mean patient-rated hand and wrist score was 15.2 (range: 10-35). The mean quick disabilities of the arm, shoulder and hand questionnaire score was 1.3 (range: 0-9). The mean foot function index on follow-up was 2.86 (range: 2-3). There was no tumor recurrence. One patient had a pathological fracture with resultant shortening of the finger on follow-up., Conclusions: In our series en bloc resection and matched nonvascularized toe phalangeal transfer resulted in a functional tumor-free digit with a low complication rate and no recurrences., Type of Study/level of Evidence: Therapeutic V., Competing Interests: Conflicts of Interest No benefits in any form have been received or will be received related directly to this article., (Copyright © 2024 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)

Background and objective. Malignant tumors of the hand, although exceptional, often have characteristics that are unique to their particular anatomical location. The optimal treatment for these tumors is controversial: conservative surgery versus amputation. Our objective was to evaluate lowest recurrence rate, complications after the surgical technique and surgical techniques currently used according to the type of malignant tumor. The question was: which procedure has the lowest recurrence rate for malignant tumors of the hand: conservative surgery or amputation? Methods. Systematic review under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, only those articles published between 2011-2021, written in the Spanish and English languages and that are free and in full text, were taken into account. The data bases reviewed were: PubMed, SciELO and Google Scholar. To manage biases, the Cochrane tools--RoB 2, ROBINS-I y robvis--were used. Results. The adverse effects presented were local recurrence, recurrence, metastatic spread, and flap failure. In turn, the recurrence rate after the application of the surgical technique ranged between the studies from 0 % to 35%. Conclusions. The lowest recurrence rate occurred after amputation. When performing conservative surgery, there are greater complications compared to amputation. Conservative techniques are the most used. [ABSTRACT FROM AUTHOR]

Background: Benign tumors of the hand present in a wide array of histological subtypes and compose most of the bony tissue tumors in the hand. This study evaluates the characteristics and treatment of benign bone tumors in light of one institution's experience. Methods: Histologically confirmed benign tumors of the hand were retrospectively identified using International Classification of Diseases codes from 1992 to 2015. A medical chart review was conducted to collect patient characteristics and tumor epidemiology and treatment. Results: A total of 155 benign bone tumors were identified. The median age of patients at the time of surgery was 39.9 ± 12.8 years. All bone tumors were located in the digits, and most were treated by intralesional curettage (n = 118, 76%). Pathologic fractures occurred in 79 bone tumors (51%). Conclusion: Enchondromas (n = 118, 76%) were the most common bone tumor in this series, whereas giant cell tumors were the most destructive and also had the highest recurrence rate (40%). Awareness of tumor features may help physicians with diagnosis, and awareness of recurrence rates is important when counseling patients. [ABSTRACT FROM AUTHOR]

Bizarre parosteal osteochondromatous proliferation (BPOP) is a rare lesion that usually arises in short bones of the hand and feet. It is typically seen in the third and fourth decades, seldom seen in the pediatric age group. A 6-year-old girl was presented with swelling over the ring finger of the left hand. The radiograph showed ectopic calcification and periosteal reaction in the ring finger. Computed tomography was performed, and a BPOP diagnosis was made on the preoperative finding. Excision of the lesion with overlying pseudocapsule and decortication was performed with a piezoelectric device. The patient is currently in a routine follow-up without recurrence. There is not enough data for treatment and follow-up BPOP in pediatric patients. The present case would contribute to the literature in the management of this rare presentation. [ABSTRACT FROM AUTHOR]

Background: Tumors of the hand are usually benign in nature, and therefore, treatment is usually nonessential. Indications for the surgical treatment are cosmetic concern and potential for malignancy. Since malignant hand tumors are seen very rarely, suspicious findings should be assessed thoroughly, and the diagnosis should be established as well. The purpose of this article is to evaluate those lesions that commonly arise in the hand region including lipomas, ganglion cysts, and glomus tumors as well as malignant tumors such as soft-tissue sarcomas and squamous cell carcinomas. Material and Methods: A retrospective review of all 528 surgically removed primary skin and soft-tissue tumors of the hand at our department between 1996 and 2016 was performed. Results: A total of 528 patients were evaluated in this study. The most common benign tumor of the hand was pyogenic granuloma (24%), and the most common malign tumor of the hand was squamous cell carcinoma (65.2%). Malignant tumors incidence was higher in males, whereas benign tumors incidence was higher in females. Conclusions: A careful history and physical examination performed by a specialist can narrow down the possibilities regarding the type of tumor. The vast majority of hand tumors tend to be benign. In contrast to skin cancers in general, those occurring on the hand frequently have a worse prognosis, with a greater propensity for recurrence, metastatic spread, and functional deficit.

Background: A synovial cyst is a herniation of synovial tissue through a joint capsule, often mistaken for a ganglion cyst. The key distinctions are that synovial cysts have a synovial cell lining, while a ganglion cyst is delineated by dense fibrous connective tissue. Typically found near joints, synovial cysts are associated with conditions like osteoarthritis, prevalent in females aged 20 to 50. We present a rare case of a synovial cyst in the extensor digitorum superficialis of the right hand., Case Summary: A 53-year-old Hispanic female visited our hand clinic due to a 3-year history of pain on the back of her right hand. At exploration, a 3 × 3 cm soft tumor was identified. Surgery revealed a clear-yellowish mass within the extensor digitorum superficialis tendon. Following the surgery, synovial cyst was confirmed by pathology and the patient was discharged without complications., Conclusion: This case highlights the rare presentation of an intratendinous synovial cyst and emphasizes the importance of a comprehensive understanding of synovial cysts in the differential diagnosis of hand tumors., Competing Interests: All the Authors have no conflict of interest related to the manuscript., (© 2024 The Author(s).)

A relatively rare tumor, osteoid osteoma most commonly affects the lower extremity. In 10% of the cases, it can affect the hand and wrist. We present a case of osteoid osteoma in the proximal phalanx of ring finger that was initially misdiagnosed as a soft tissue lesion. The soft tissue lesion was resected, but the symptoms recurred shortly thereafter, leading to repeat diagnostic workup. Despite X-rays, magnetic resonance imaging, and tissue biopsy, the diagnosis remained elusive until surgical re-exploration. Based on the lessons learned from this case and the experience reported in literature, we discuss the intricate nature of osteoid osteoma diagnosis in the hand, the obstacles often encountered, and how to approach these challenging patients in a stepwise and critical fashion. [ABSTRACT FROM AUTHOR]

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Introduction: A lipoma is a benign tumor of the adipose tissue and the most common tumor of the subcutaneous tissue which is most commonly found on the trunk. It appears as a round or oval subcutaneous mass of soft consistency, which is not attached to the skin or to the deeper tissues. Its growth can cause compressive symptoms, the most common being pain and paresthesia. Case report: Considering the fact that lipomas very rarely occur in the hand and foot, in this paper we present a case of a large lipoma in the hand of a 70-year-old female patient, with a subcutaneous tumor, in the area of the ulnar side of the left palm, and the pain and tingling in the fourth and fifth finger. Longitudinal incision on the medial side of the palm and transversal incision up to the proximal palmar crease were performed under general endotracheal anesthesia. The extirpated tumor was, due to its dimensions (5.6 x 3.4 x 2.5 cm), categorized as a giant hand lipoma. A histopathological analysis confirmed the diagnosis of lipoma. Conclusion: A hand lipoma requires surgical treatment exclusively, involving a qualified hand surgeon, which is important because of the high functional and aesthetic importance of the hand.

Glomus tumors are rare, accounting for only 1–5% of hand soft tissue tumors, typically located beneath the nail. This case report presents a 56-year-old female who experienced severe pain from a glomus tumor that went undiagnosed for five years. Despite an equivocal Hildreth's sign, magnetic resonance imaging successfully identified the tumor, which was surgically excised and confirmed histologically. This case underscores the critical role of clinical tests, imaging, and physical examination in the diagnosis and management of glomus tumors. It also highlights the ongoing issue of misdiagnosis and the need for continued medical education to improve diagnostic accuracy and reduce healthcare inefficiencies associated with delayed diagnoses.

The majority of osseous tumors of the hand are benign. The surgeon who evaluates and treats osseous tumors of the hand has to be familiar with limb anatomy, tumor biology, various presentations of the tumors and the range of treatment possibilities and their limitations. Lesions in the hand more often present earlier in their course than those at other sites, just because they are more likely to superficial and easily noticed. A review of all cases of osseous tumors of the hand, seen by a hand surgeon over the last 10 years, at Imam Khomeini hospital was performed. Among 55 cases with osseous tumors of hand, 48 primary benign bone tumors, 3 primary malignant bone tumors, and 4 metastatic bone tumors were found. Enchondroma was the most common benign bone tumor followed by osteoid osteoma, osteoblastoma, aneurismal bone cyst, giant cell tumor, epidermoid cyst, and osteochondroma. There were two chondrosarcoma and one Ewing’s sarcoma as primary malignant bone tumors. Metastasis to the hand from colon, esophagus, and breast were also found. There were also two cases with Brown tumor secondary to hyperparathyroidism, we conclude that a variety of osseous tumors could occur in the hand, and usually they are benign. Although malignant neoplasms in the hand that arise from tissues other than the skin are very rare, the hand may be the site of distant breast, lung, kidney, esophagus, or colon adenocarcinoma metastases, most of which have a predilection for the distal phalanges.

Digital papillary adenocarcinoma (DPA) is a rare and aggressive tumor arising from the eccrine sweat glands. It is found on the hands and feet and most commonly occurs on the volar and distal finger tips. In this report, we describe a DPA in a 45-year-old woman who presented with a slowly enlarging mass on the dorsal aspect of her proximal ring finger. This report shows that DPA may clinically present as a relatively benign-appearing mass and in an atypical location. Surgical excision, followed by histologic and immunohistochemical evaluations of even benign-appearing digital masses, is important because this is the only way a DPA can be diagnosed. [ABSTRACT FROM AUTHOR]

Background: Aneurysmal bone cysts are an uncommon form of benign primary bone tumors; affection of the hand is very rare. Methods: A rigorous review of the literature showed that this type of tumor has not previously been described in the pisiform. In this article, we report the occurrence of an aneurysmal bone tumor in the pisiform of the left hand of a 19-year-old male. Results: This tumor was successfully treated through surgical excision with an uneventful recovery. We describe the process behind the diagnosis of the lesion and the subsequent treatment in an attempt to highlight the rare but possible occurrence of aneurysmal bone cysts in the pisiform. Conclusion: Appropriate treatment of aneurysmal bone cysts in this location is required, due to the anatomical nature of the pisiform itself with the risks of pathologic fracture and ulnar nerve compression. [ABSTRACT FROM AUTHOR]

Giant cell tumors are primary bone tumors most often observed in the metaepiphyses of long bones; location in the hand, especially the carpal bones, is rare. We report a patient with recurrent giant cell tumor of the capitate and discuss treatment and prognosis in this rare site. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Epidemiologic data concerning hand and wrist tumors are still few and sometimes conflicting. In our department, tumor surgeons and hand surgeons manage together those tumors and they have a specific recruitment. This collaboration permitted to make an epidemiologic study of the tumors of the hand operated in the unit. Methods: We made a retrospective study of all the cases of wrist and hand tumors operated in the unit, from January 1980 to September 2008. Files were collected from diagnostic encoding, letters of consultations and the register of the department of histology. Results: The mean age of the population was 48 years (from 16 to 94 years). The series included 623 tumors treated in 620 patients (372 women and 248 men). Tumors concerned soft tissues in 525 cases (84.1%), bone tissue in 70 cases (11.4%) and skin in 28 cases (4.5%). The prevalence of malign tumors was 1.3% in this study. Conclusions: This series is the third in number of cases and the data are comparable of those from other studies. The prevalence of bone tumors (11.4%) is higher than in others studies (from 1.6 to 6.6%) and the prevalence of skin tumors is lower. Except for skin tumors which recruitment modalities are more variable, this series seems to be a good reflection of the prevalence of the different types of hand and wrist tumors. [Copyright &y& Elsevier]

Myopericytoma (MPC) is a rare benign soft tissue neoplasm that arises from perivascular smooth muscle-like myoid cells that share features of both glomus and smooth muscle cells. It usually slow growing solitary tumor that might mimic aggressive sarcoma. 45 years old male, with unremarkable medical history, presented with fast growing mass on the left 1st webspace that was noticed 6 months prior to presentation. Investigations with US and MRI showed highly vascular solid mass that was worrisome for malignant lesion. Surgical excision was done and histopathology confirmed the diagnosis of myopericytoma. MPC is a rare perivascular neoplasm that's reported mainly in the extremities with lower limbs are most affected sites. Usually it presents as solid painless slowly growing mass. However, Multiple papers reported different rare presentations like multiple, painful and some with malignant transformation. MPC is a benign tumor that might mimic aggressive sarcoma. Such cases should be approached with high suspicion and proper investigation and management should be followed promptly. • Myopericytoma (MPC) is a rare benign soft tissue neoplasm. • It usually slow growing solitary tumor that might mimic aggressive sarcoma. • It occurs mainly in the extremities with lower limbs are most affected sites. • High suspicion and proper investigation and management to achieve proper diagnosis [ABSTRACT FROM AUTHOR]

We present the case of a 59-year-old man with a 6-cm diameter tumor on his left hand of 40 years duration. After radiograph and MRI studies, the tumor was excised. The pathological study revealed an aponeurotic calcifying fibroma that was confirmed after electronic microscopy. The size of this tumor was exceptional. One year postoperatively, there were no signs of local recurrence. [ABSTRACT FROM AUTHOR]

Background: To document the clinical presentation of glomus tumors of the hand and evaluate the outcome of complete surgical excision in terms of relief of symptoms, any postoperative nail deformities and tumor recurrence over a period of one year., Methods: This descriptive case series spanned over a period of twelve years. All patients of either gender and all ages who had histologically confirmed glomus tumors of the hands were included. All of them underwent surgical excision under local anesthesia., Results: Out of 17 patients, majority (n=12; 70.58%) were females. The mean age was 41.17±13.7 years. The dominant hand was involved in 11 (64.70%) patients. There were 14 patients (82.35%) with subungual tumors whereas 3(17.64%) had volar pulp glomus tumors. The mean diagnostic delay was 18.88±9.3 months. The tumor size ranged from 2 mm to 1.1cm with a mean of 4.05±4.3mm. All the patients (n=17,100%) experienced complete symptomatic relief within 2-4 weeks after surgical excision. There were no postoperative nail deformities. There was no recurrence over a period of one year., Conclusion: Glomus tumors of the hands were more frequently found among women in their fourth and fifth decades. Dominant hand, index finger and distal phalanx represented the commonest affected anatomic locales. Majority of the tumors were subungual. Majority of the patients suffered over 12 months in distressful pain before being diagnosed. Complete surgical excision under local anesthesia provided rapid relief of the symptoms. Creation of awareness about the tumor among doctors as well as public would help to ensure early presentation to plastic surgeon, prompt diagnosis and hence avoidance of the prolonged periods of agonizing misery.

Musculoskeletal tumors of the hand are a rare entity and are divided into skeletal and soft tissue tumors. Either category comprises benign and malignant or even intermediate tumors. Basic radiology allows an optimal resolution of bone and related soft tissue areas, ultrasound and more sophisticated radiologic tools such as scintigraphy, CT and MRI allow a more accurate evaluation of tumor extent. Enchondroma is the most common benign tumor affecting bone, whereas chondrosarcoma is the most commonly represented malignant neoplasm localized to hand bones. In the soft tissues, ganglions are the most common benign tumors and epithelioid sarcoma is the most frequently represented malignant tumor targeting hand soft tissues. The knowledge regarding diagnostic and therapeutic management of these tumors is often deriving from small case series, retrospective studies or even case reports. Evidences from prospective studies or controlled trials are limited and for this lack of clear and supported evidences, data from the medical literature on the topic are controversial, in terms of demographics, clinical presentation, diagnosis, prognosis and therapy. The correct recognition of the specific subtype and extension of the tumor through first line and second line radiology is essential for the surgeon, in order to effectively direct the therapeutic decisions., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Soft tissue tumors involving the hand are common and most often benign. It is important to know the spectrum of soft tissue tumors of the hand and understand the typical as well as atypical imaging features are seen on different imaging modalities. The imaging features are largely determined by the tumor histopathology; thus, the basic idea about the tumor histopathology will always be useful. This article intends to focus on a comprehensive approach including demographics, clinical presentation, and imaging findings required to diagnose the tumor definitely or narrow the differentials. This article discusses common soft tissue tumor mimics of the hand as well, however, excludes the bone tumors for the sake of brevity., Competing Interests: There are no conflicts of interest.

Purpose: Deep palmar tumors of the hand are very rare, and reported cases are usually benign. The most important issue is frequent anatomical variations with challenging surgical exposure and excision of these lesions. Some case reports or a small series of patients have been reported in the literature. The aim of this study was to present our experience with the deep palmar tumors of the hand., Patients and Methods: In the study, retrospective analyses of 43 patients treated with deep palmar tumors of the hand between January 1998 and June 2015 were evaluated. Tumors and tumor-like pathologies of the deep palmar space of the hand were retrospectively evaluated according to age, gender, localization, preoperative symptoms, size, site, treatment methods, histopathology, and early and late complications. Statistics and data analyses were also performed., Results: All 43 pathologies were benign, and histopathologic diagnoses were 10 lipomas, 8 ganglions, 5 giant cell tumor of the tendon sheath, 4 schwannomas, 3 hemangiomas, 3 palmar fibromatosis, 2 epidermal cysts, 2 neurofibroma, 1 angiolymphoid hyperplasia with eosinophilia, 1 granuloma, 1 calcifying aponeurotic fibroma, 1 digital fibroma, 1 foreign body granuloma, and 1 lipofibromatous hamartoma. The most common complication was temporary numbness and paresthesias of the digits. Marginal excision was performed in 40 patients, excision with nerve grafting in 2 patients (with neurofibroma) and carpal tunnel release in one patient with lipofibromatous hamartoma., Conclusion: In the deep palmar space of the hand, pathologies are closely associated with tendons, muscles, and neurovascular structures. Preoperative magnetic resonance imaging is helpful for the preoperative diagnosis, evaluating tumor extension, and successful surgical planning. Level of Evidence: IV Therapautic.

Chordomas are low-grade malignant tumors that are locally aggressive and have the potential to metastasize. They most often occur in the sacrococcygeal and spheno-occipital portions of the vertebral column. Morphologically similar tumors have been found outside the axial skeleton and are referred to as extra-axial chordomas. Several case reports have described the radiologic, microscopic, and immunologic profiles of these tumors and their similarities to axial chordomas. The authors report a 24-year-old man who presented with a mass in his left hand and underwent surgical excision. Specimens stained positive for pancytokeratin, S100, and brachyury. Brachyury is a protein that is present during embryogenesis and is expressed by chordomas. This is the first report of an extra-axial chordoma within the interosseous muscle compartment of the hand in a young patient. [ABSTRACT FROM AUTHOR]

Primary malignant tumors of the hand are rare. Most cases present to clinics unaffiliated with cancer centers, making it incumbent on all hand surgeons to understand the pathology indicative of malignancy and the proper course of treatment of hand neoplasms. In this review, we report, based on tumor type, the anatomical considerations, proper management, staging, surgical approaches, reconstructive considerations, and long-term surveillance of primary malignant tumors of the hand., (© 2018 Wiley Periodicals, Inc.)

Background: Tumors involving the hand skeleton are rare. However, a basic knowledge of hand tumors is necessary for every clinician. This is due to the importance of distinguishing typical benign tumors from life or limb threatening malignant ones., Methods: This study is a review of 99 cases of osseous hand tumors presented to the department of orthopedic surgery, Imam Khomeini Hospital in Tehran, Iran, from December 1990 to February 2011., Results: Ninety-one cases were benign osseous tumors of the hand and eight tumors were malignant which four of them were considered as primary and four considered as metastatic type. The most common benign tumors were enchondroma and osteoid osteoma. Other benign tumors were epidermoid bone cyst, giant cell tumor of the bone, aneurysmal bone cyst, osteoblastoma, and osteochondroma. Primary malignant tumors were extremely rare and we have reported two chondrosarcomas, one osteosarcoma and one Ewing's sarcoma involving the hand skeleton., Conclusion: This study indicates that the history, physical examination, laboratory and radiographic data as well as clinicians' knowledge of specific hand tumors are required for the best management strategy. New techniques could lead to earlier diagnosis, prevent complications and indentify the most effective type of treatment.