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J Hand Surg Am. 2018 Dec;43(12):1123-1129. doi: 10.1016/j.jhsa.2018.03.032. Epub 2018 Jun 19.

Clinical Decision Making for a Soft Tissue Hand Mass: When and How to Biopsy.

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Department of Orthopaedic Surgery, Stony Brook University, Stony Brook, NY. Electronic address:
Department of Orthopaedic Surgery, University of Illinois at Chicago, Chicago, IL.


Evaluation of a hand mass and subsequent surgical treatment is a frequent clinical encounter for the practicing hand surgeon. The clinical evaluation of benign and malignant hand tumors has traditionally focused on diagnosis, surgical excision, and reconstruction. There is a paucity of literature discussing the determining factors for a hand mass biopsy, its appropriate technique, and postbiopsy preparation and handling. This review discusses the approaches of the hand surgeon and orthopedic oncologist to a soft tissue mass in the hand and clarifies the term biopsy. Special attention is focused on preoperative decisions and indications for core needle, incisional, and excisional biopsies of hand masses. In addition, we include a discussion of surgical technique for obtaining a specimen, processing a specimen, and sending a specimen for pathological evaluation. This highlights specimen labeling and type of fixative utilized for pathological evaluation. This review features a section detailing clinical strategies to reduce morbidity associated with evaluation and treatment of benign and malignant hand masses and is based on recommendations from a synopsis of expert opinion and literature review.


Biopsy; hand mass; mass excision

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