CASE REPORT
Atsushi Miyake Æ Hideo Morioka Æ Hiroo Yabe
Ukei Anazawa Æ Takeshi Morii Æ Keiko Miura
Makio Mukai Æ Shinichirou Takayama
Yoshiaki Toyama
A case of metacarpal chondrosarcoma of the thumb
Received: 9 November 2005 / Published online: 24 March 2006
Ó Springer-Verlag 2006
Abstract Enchondroma is the most common primary
benign bone tumor of the hand. Chondrosarcomas
in this location, however, are extremely rare. It often
is difficult to make a histological distinction between
benign cartilaginous tumors and low-grade chondro-
sarcomas, because enchondromas at this site often show
histological features suggestive of malignancy. However,
distinguishing the two conditions is clinically relevant
because chondrosarcomas of the hand require prompt
and more radical treatments such as ray amputations.
On the other hand, Mankin has recently given attention
to a less aggressive behavior of chondrosarcomas of the
phalanges compared with those of other locations. And
also, ray amputation does not cause much functional
deficit in the finger but does for the thumb. This is a case
report of chondrosarcoma affecting the metacarcal
bone of the thumb, treated by en block resection and
preserving the function of the thumb by bone graft
reconstruction, with reference to the literature.
Keywords Chondrosarcoma Æ Metacarpal bone Æ
Thumb Æ Treatment Æ Function
Introduction
Enchondroma is the most common primary cartilagi-
nous bone tumor of the hand, located predominantly in
the phalanges. On the other hand, chondrosarcomas,
which are malignant counterpart of enchondromas, are
uncommon in this location [1]. The diagnosis of chon-
drosarcomas of the hand sometimes poses problems to
orthopedic oncologists and pathologists alike. That is
the reason why the biologic behavior of chondro-
sarcomas in this location is usually benign, although
enchondromas of the hand often show histological fea-
tures suggestive of malignancy [2–4]. However, distin-
guishing the two conditions is clinically relevant because
chondrosarcomas of the hand require prompt and more
radical treatment, as these are locally aggressive [5]. On
the other hand, chondrosarcomas in this location are
necessary to be considered as distinct lesions, different
from chondrosarcomas in other locations, especially in
view of the frequent discrepancy between their omi-
nous histological appearance and much lower metastatic
potential in this location than other locations [6, 7]. We
recently encountered a case of chondrosarcoma of the
metacarpal bone of the thumb. This case is presented in
this paper, with reference to the literature.
Case report
The patient was a 53-year-old Japanese woman, with the
chief complaint of a painful mass in her right thumb.
Her past and family history was unremarkable.
History of present illness Around September 2002, the
woman noticed a mass near the metacarpophalangeal
(MP) joint of her right thumb. The mass grew in size
gradually and became painful, and she consulted a
nearby clinic in November of the same year. The plain
X-ray and MRI findings suggested a malignant bone
tumor. She was therefore referred to our department and
hospitalized on December 16, 2002.
A. Miyake Æ H. Morioka (&) Æ H. Yabe Æ U. Anazawa
T. Morii Æ K. Miura Æ Y. Toyama
Department of Orthopaedic Surgery,
School of Medicine, Keio University,
35 Shinanomachi, Shinjuku-ku, 160-8582 Tokyo, Japan
E-mail: morioka@sc.itc.keio.ac.jp
Tel.: +81-3-53633812
Fax: +81-3-33536597
M. Mukai
Department of Diagnostic Pathology,
Keio University Hospital, 35 Shinanomachi,
Shinjuku-ku, 160-8582 Tokyo, Japan
S. Takayama
Division of Orthopedics,
National Center for Child Health and Development,
2-10-1, Okura Setagaya-ku, 157-8535 Tokyo, Japan
Arch Orthop Trauma Surg (2006) 126: 406–410
DOI 10.1007/s00402-006-0134-5