Malignant bone tumors of the carpus are extraordinarily uncommon. Osteosarcoma, the most common malignant bone tumor, has only been reported in the carpus twice in the English literature [64,65]. Bickerstaff and colleagues  describe a 66-year-old female who had osteosar-coma of the trapezium, causing symptoms similar to arthritis of the thumb carpometacarpal joint. Marcuzzi and colleagues  tell of an osteosar-coma of the scaphoid mistaken for a benign lesion and treated with curettage and bone grafting.
Chondrosarcoma is the most common malignant bone tumor of the hand, but it too has only been reported twice in the carpus [66,67]. Of 30 cases in the hands and feet, Dahlin and colleagues  identified one case in the trapezoid. Gran-berry and Brylan  encountered a case in the trapezium initially treated as carpometacarpal arthritis of the thumb. Of interest, all four cases of these malignant bone tumors occurred near the base of the thumb, and a malignant process was not suspected. These cases re-emphasize the need for the hand surgeon to maintain a high level of vigilance when reviewing any radiographic studies, even when the diagnosis seems straightforward.
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