Hand Tumors — Benign Masses, Bone Lesions, Sarcomas, and Oncologic Reconstruction

This episode reviews the core principles of benign and malignant tumors of the hand, focusing on evaluation, imaging, biopsy technique, tumor biology, and reconstructive decision-making.Topics include the initial workup of a hand mass, including key history clues such as cold hypersensitivity in glomus tumors, NSAID-responsive night pain in osteoid osteoma, and systemic clues for gouty tophi. The episode also reviews essential physical exam steps, including Allen’s test, regional lymph node examination, and the importance of distinguishing infection, inflammatory disease, and malignancy.Benign soft tissue and bone tumors are reviewed, including ganglion cysts, mucous cysts, giant cell tumor of tendon sheath, epidermal inclusion cysts, schwannoma, neurofibroma, lipofibromatous hamartoma, glomus tumor, pyogenic granuloma, enchondroma, osteoid osteoma, and giant cell tumor of bone. Key concepts include recurrence risk, pressure erosion, pathologic fracture timing, nail bed repair, and when to obtain chest imaging.Malignant hand tumors are discussed through squamous cell carcinoma, melanoma, epithelioid sarcoma, synovial sarcoma, chondrosarcoma, osteosarcoma, and acrometastasis. The episode emphasizes biopsy principles, avoiding Esmarch exsanguination in suspected sarcoma, longitudinal incision planning, Enneking margins, melanoma Breslow-depth margins, sentinel lymph node biopsy, and the reconstructive role of free tissue transfer after oncologic resection.Clinical strategy is framed around the dual responsibility of hand oncology: achieving safe margins while preserving as much sensation, tendon glide, vascularity, skeletal stability, and functional hand use as possible. Part of Dr. Lara’s Plastic Surgery Compendium — a high-yield audio reference for plastic surgery trainees and surgeons.Disclaimer:This podcast is intended for educational purposes only and is designed for medical students, residents, fellows, and practicing healthcare professionals. It is not intended to provide medical advice, diagnosis, or treatment for any individual patient. The content presented reflects general surgical principles and should not be used as a substitute for formal medical training, clinical judgment, or consultation with qualified healthcare professionals. Listening to this podcast does not establish a physician–patient relationship.SEO / Topic Keywordshand tumors, hand mass evaluation, ganglion cyst, mucous cyst, giant cell tumor of tendon sheath, PVNS, epidermal inclusion cyst, schwannoma, neurofibroma, lipofibromatous hamartoma, glomus tumor, Love pin test, Hildreth sign, pyogenic granuloma, enchondroma, pathologic fracture, Ollier disease, Maffucci syndrome, osteoid osteoma, giant cell tumor of bone, squamous cell carcinoma hand, melanoma hand, Breslow thickness, sentinel lymph node biopsy, epithelioid sarcoma, synovial sarcoma, Enneking staging, sarcoma biopsy, chondrosarcoma hand, osteosarcoma hand, acrometastasis