Surgical Options for Malignant Skin Tumors of the Hand

• Main Authors: Min Ji Yun, Ji Ung Park, Sung Tack Kwon
• Format: Article
• Language: English
• Published: Korean Society of Plastic and Reconstructive Surgeons 2013-05-01
• Series: Archives of Plastic Surgery
• Subjects: Skin neoplasms; Melanoma; Carcinoma; squamous cell; Surgical flaps
• Online Access: http://e-aps.org/Synapse/Data/PDFData/2023APS/aps-40-238.pdf

Background  Primary malignant tumors of the hand, although unusual, may present variedand often complex clinical problems. Themain treatmentmodality ofskin cancer ofthe handhas changed.Methods  We retrospectively reviewed the medical records of 43 patients who underwentsurgery formalignantskin tumors ofthe hand during an 18-year period,fromSeptember 1994to February 2012. The characteristics of the tumor, methods of reconstruction, and long-termresultswere 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. Thirtyfour cases occurred on the fingertip (16 ofthose cases on the thumb), 5 cases occurred on thepalm, and 4 cases on the dorsum ofthe hand. Amputationwas mostfrequently used in earlycases, but recently, tissue-sparing excision has been performed frequently. The incidence oflocal recurrence was 3 cases and distant metastasis was 1 case, and the 5-year survival ratewas 100%, exceptin 4 cases due to follow-up loss.Conclusions  The principles of treatment-to be curative and to preserve function andappearance-are important points. “Preservative surgery” preserves function and cosmesis ofthe involved finger or hand dorsum or palm. Preservative surgery not only emphasizes lessresection and surgery of a smaller scale, but also optimal reconstruction of the soft tissuedefect ofthe digit.