Answer:
Osteogenic sarcoma is the most common primary bone tumor seen in children and adolescents, but it is only rarely seen as a primary lesion in the hand. When it does occur in the hand it may be in older patients in the fourth, fifth, and sixth decades. This lesion most commonly occurs in the proximal phalanges and metacarpals. The histological diagnostic criterion involves production of osteoid or bone by malignant cells. Plain radiographs may reveal an expansile, sclerotic lesion with malignant new bone formation or with a more lytic or mixed pattern with destruction of soft tissue mass. The lesion should be treated with wide en bloc excision or finger or ray amputation. Currently adjuvant chemotherapy is considered to be part of a comprehensive treatment plan. There is no role for external beam radiation in the attempted curative treatment of these lesions.