The hand in metastatic disease.

A review of the world literature shows 163 cases of tumors metastatic to the hand; we report three additional cases. The incidence of primary tumors elsewhere metastasizing to the hand is a little more than 0.1%. In over 16% of cases, a tumor of the hand was the first manifestation of a primary tumor elsewhere. The lung is the chief source, followed by the breast and the kidney. The terminal phalanges are the most frequent site of metastasis, followed by the metacarpals and the proximal phalanges. The mechanism of dissemination remains obscure.