A review of 129 hand tumors suggests that diagnosis of a swelling in the hand is often uncertain because of the close proximity of many different tissues in a small volume. Histologic diagnosis is necessary to assure appropriate treatment; excisional biopsy should be done whenever possible; if the lesion is benign, treatment has been completed; in the event the lesion is malignant, further treatment will not have been materially compromised. The margin of normal tissue around malignant lesions often precludes treatment of such tumors of the hand by ray resection or wide local excision because adequate wide excision will frequently leave nothing functional. Attempts at wide local excision are ofter compromised by the surgeon's natural desire to preserve function; this frequently results in incomplete removal of the tumor. The function preserved will be of little benefit to a patient with widespread metastases.