Maligne Knochentumoren der Hand

Zusammenfassung

Maligne Knochentumore sind vergleichsweise selten. Die histologischen Subtypen (Chondrosarkom, Osteosarkom, Ewing-Sarkom) manifestieren sich bevorzugt an verschiedenen Skelettabschnitten. An der Hand sind Chondrosarkome der häufigste maligne Tumortyp. Leitsymptome maligner Knochentumore an der Hand wie allgemein sind eine neu aufgetretene Schwellung sowie Schmerzen am betroffenen Knochenabschnitt. Diagnostisch wird durch bildgebende Verfahren (Röntgen, CT, MRT) der Lokalstatus erhoben und das onkologische Staging durchgeführt. Die definitive Therapie maligner Knochentumore sollte – aufgrund der Seltenheit – in spezialisierten Zentren erfolgen. Je nach histologischem Tumortyp und lokaler und systemischer Ausbreitung wird die chirurgische Therapie durch Chemo- bzw. Radiotherapie komplettiert. Auch an der Hand ist die onkologisch sichere Resektion gegenüber funktionserhaltenden Resektionsmöglichkeiten vorzuziehen, was den Erhalt von Funktionseinheiten wenn immer möglich nicht ausschließt.

Abstract

Malignant bone tumors are very rare entities in the bones of the hand. The histologic subtypes (chondrosarcoma, osteosarcoma, Ewing-sarcoma) preferentially manifest in varying regions of the skeleton. Chondrosarcomas are the most frequent malignant bone tumor type in the hand. Cardinal symptoms of malignant bone tumors in the hand and in general are a new swelling and pain in the affected bones. The primary diagnostic tools are radiologic techniques (x-ray, CT, MRI) for assessment of local tumor growth and the oncologic staging. A definitive treatment of malignant bone tumors should be carried out in specialized centers, as these tumors are rare. Surgical therapy is completed by chemo- or radiotherapy, if required because of histologic subtype and local or systemic spreading. Safe margins of tumor resection should be preferred to function-preserving treatment for tumors of the hand while the preservation of functional units should be pursued whenever possible.

Schlüsselwörter

Hand - Knochentumoren - Strahlresektion - multimodale Therapie - Enchondromatose

Key words

hand - bone tumors - ray resection - multimodal therapy - enchondromatosis

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