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The sites of local and remote extension of primary epithelioid sarcoma of the hand and wrist were studied in six patients. The tumor was found to spread to noncontiguous areas of skin, subcutaneous tissue, fascia, bone, and lymph nodes as well as by direct extension along fascial planes. Neither local nor remote extension of the tumor could be determined accurately or dependably by clinical examination, radiography, xerography, lymphangiography or radioisotope scanning. Wide en bloc excision of the tumor or amputation is recommended as the primary treatment of epithelioid sarcoma of the hand. Axillary node dissection is advised in all cases.
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