Chondrosarcomas of the phalanges of the hand.

OBJECTIVES: This study aims to evaluate the diagnosis and treatment approaches of the rarely seen chondrosarcomas of the phalanges of the hand. PATIENTS AND METHODS: Fifty-two patients (27 males, 25 females; mean age 41.2 years; range 12 to 70 years) with chondroid lesions localized in hand phalanges who were performed surgical treatment between December 2012 and September 2016 were retrospectively reviewed. The study included 62 phalangeal chondroid lesions. Patients' mean follow-up duration was 60.6 months (range 13 to 165 months). Incisional biopsy was performed for the diagnosis. One patient with bilateral and multiple involvement was performed tru-cut biopsy. Phalangeal chondrosarcoma was diagnosed in five patients (9.6%). RESULTS: Of the chondroid lesions, 37 were localized in proximal phalanges (59.6%), 16 in midphalanges (25.8%), and nine in distal phalanges (14.6%). Chondrosarcoma was detected in 15 phalanges of five patients. Of the two patients with Ollier disease, localization was detected in nine phalanges (four proximal, two mid, three distal phalanges) of one patient and in three phalanges (one proximal, two midphalanges) of the other patient. None of the patients had distant metastasis on diagnosis. Ray amputation was performed in two patients under general anesthesia and amputation was performed in one patient. One patient did not give consent for operation. The other patient with Ollier disease gave consent for amputation of only one finger. No local recurrence was seen. CONCLUSION: The hand localization of chondrosarcomas is rare with scarce information in the literature. Their metastasis potential is low but local recurrence rates are high after insufficient surgery. Amputation or ray amputation is the applicable treatment.

Management of solitary fibrous tumors localized in extremity: case series and a review of the literature.

OBJECTIVES: This study aims to evaluate the clinical characteristics and treatment results of patients with a diagnosis of solitary fibrous tumor localized in extremity. PATIENTS AND METHODS: Clinical findings, treatment methods, clinical outcomes and treatment failures of seven patients (3 males, 4 females; mean age 49.7±20.7 years; range 22 to 79 years) diagnosed as solitary fibrous tumor localized in extremity between January 2005 and December 2016 were evaluated retrospectively. RESULTS: Most frequent localization was the thigh (42.8%, n=3). Mean tumor size was 10.8±2.4 cm (range 8-15 cm). All patients applied with painless mass and all had primary tumor. All patients had localized disease at the time of diagnosis. Postoperative mean follow-up duration was 44.4 months (range 13-121 months). Marginal resection was performed in two patients at low risk group while wide resection was performed in other patients at moderate and high risk groups. Patients who underwent marginal resection were performed adjuvant radiotherapy. No recurrence or metastasis was detected in any of the patients during follow-up. CONCLUSION: In the treatment of solitary fibrous tumors localized in extremity, marginal resection together with radiotherapy may be an alternative treatment method for patients in low risk group according to risk stratification model, for whom wide resection is not possible. Wide resection is recommended in moderate and high risk groups to decrease local recurrence and metastasis risks.