Review Article

Management of soft tissue tumors of the upper extremity: a review

¹ University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093, USA
² Division of Plastic Surgery, University of California, San Diego, 200 W Arbor Drive, San Diego, CA 92103, USA
³ Department of Orthopedic Surgery, University of California, San Diego, 200 W Arbor Drive, San Diego, CA 92103, USA

^* Corresponding author: akulidjian@ucsd.edu

Received: 12 October 2016
Accepted: 28 December 2016

Abstract

Introduction: Management of malignant tumors of the hand and wrist is challenging and is generally approached by limb salvage or amputation. With advances in care, amputation has been superseded by limb salvage as the treatment of choice.

Methods: A narrative literature review was performed to identify articles on the topic of management of soft tissue tumors of the upper extremity, including surgical management, adjuvant radiation therapy, and chemotherapy.

Results: A total of 29 articles were selected. Earlier reports favored radical tumor resection, which often led to amputation, whereas later articles demonstrated limb salvage as the preferential treatment modality.

Conclusions: Given the detrimental effects on function and psychologic outcomes, amputation has been superseded by limb salvage in most cases, although it can occasionally be the only option. A variety of adjuvant therapies have been described, including radiation or brachytherapy, chemotherapy, and regional hyperthermia. Radiation treatment, and specifically brachytherapy, is beneficial to select patients. Controversy surrounds chemotherapy in certain subtypes, and regional hyperthermia requires further investigation.