Lytic Lesion in the Distal Phalanx of the Hand

Background: Both primary and secondary tumors can develop in distal phalanx of the hand presenting as lytic lesions. The presence of a lytic lesion in the distal phalanx has been a dilemma making the differential diagnoses, prognosis, and treatment of these lesions challenging. Objectives: This study was designed to evaluate the patients who were presented with a lytic lesion in their distal phalangeal bone of the hand. Patients and Methods: In this retrospective study, we reviewed the final diagnosis, clinical presentation, treatment, and outcomes of the lytic lesions in distal phalangeal bones of the hand in 14 patients who were referred to our hospital from 2008 to 2013. Results: The mean age of our patients was 36.14 ± 15.8 years. Thumb and middle finger were the most common involved digits (four cases of each) followed by the index finger (three patients). Enchondroma was the most common final diagnosis (five patients) followed by giant cell tumor and glomus tumor (two cases of each). Painless mass was the chief complaint of most patients with enchondroma, whereas pain and swelling were the chief compliant of others. Enchonromas were located in the proximal part of the distal phalanx and other lytic lesions were seen in the distal part. Conclusions: Because of the diverse diagnosis for the lytic lesions in the distal phalanx of the hand, a complete tumor work-up should be performed to evaluate the condition properly, especially in distally located lesions.