Tumor location and type affect local recurrence and joint damage in tenosynovial giant cell tumor: a multi-center study

AbstractOsteochondral destruction and a high recurrence rate after surgery are major concerns that make difficult the treatment course of tenosynovial giant cell tumor. The aims of this study were to elucidate rates of postoperative local recurrence and osteochondral destruction, as correlated with various demographic factors. Eighty surgically treated patients with intra-articular tumors (knee: 49, ankle and foot: 12, hip: 10, others: 9) were included in this study. Factors including age, disease type (diffuse/localized), location, existence of osteochondral destruction were correlated with local recurrence or development/progression of osteochondral destruction. The 5-year local recurrence free survival rate was 71.4%. Diffuse type (n = 59, localized: n = 21) (P = 0.023) and knee location (P = 0.002) were independent risk factors for local recurrence. Diffuse type (P = 0.009) was a significant risk factor, and knee location (P = 0.001) was a negative factor for osteochondral destruction at the initial examination. Progression of osteochondral destruction was observed more often in cases with local recurrence (P = 0.040) and findings of osteochondral destruction at the initial examination (P = 0.029). Diffuse type is a factor that should be noted for both local recurrence and osteochondral destruction, while local recurrence occurs but osteochondral destruction is less observed in the knee.

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CLINICAL AND MORPHOLOGICAL CORRELATIONS AND HISTOPATHOLOGY OF JOINT DAMAGE IN PATIENTS WITH DIFFUSE-TYPE TENOSYNOVIAL GIANT CELL TUMOR

Wiadomości Lekarskie ◽

10.36740/wlek201912102 ◽

2019 ◽

Vol 72 (12) ◽

Author(s):

Olena O Dyadyk ◽

Anastasiia Hryhorovska

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Cell Size ◽

Giant Cells ◽

Cell Tumor ◽

Multinucleated Giant Cells ◽

Diffuse Type ◽

Association Coefficient ◽

Mean Values ◽

Tenosynovial Giant Cell Tumor

Introduction: Tenosynovial giant cell tumor (TSGCT) (synonym – pigmented villonodular synovitis) – is a rare benign proliferative lesion of the synovial sheath, localized in the joint capsule, bursa or tendon sheath and characterized by locally destructive growth. Depending on the prevalence within the joint elements, the presence of a capsule around the tumor, histophotographic features of cell structure and clinical behavior TSGCT can be divided to localized or diffuse type. The aim of the study was researching of histopathological properties of diffuse-type TSGCT, determine the parameters its morphological indicators and to find out the correlation between these morphological and clinical parameters. Materials and methods: The research material was used biopsy (resect) of pathological lesions from 50 patients who were diagnosed and histologically verified diffuse-type TSGCT. Microscopic examinations of the stained sections and their photo archiving were carried out with use of a Olympus-CX 41 light optical microscope. Group measurable parameters (mean values and Pearson tetrachoric index (association coefficient) were calculated in groups of comparison for morphological and clinical indices of TSGCT. The mean values were compared by Student’s test, P value of ≤0.1 was considered statistically significant. Results:Correlation analysis of indicators that accounted for the pairs of cases «clinic – morphology» revealed the relationships, that had the highest parameters of the association coefficient between such indicators: «presence of villous growths» - «severity of hemosiderosis» (if hypertrophied synovial villi available, with vascular injection and pronounced proliferation of synovial cells, there is also a significant accumulation of hemosiderin pigment); «presence of villous growths» - «type of predominant cellular proliferates» (if cells of TSGCT diffuse type consists of monotonous sheets of stromal cells, with uniform, oval to reniform nuclei, the proliferation of villi in synovial layer is non-distinctive); «presence of nodes» - «kind of stroma» (if nodes predominate, their histological structure is mainly represented by polymorphic clusters of synovitis cells in the form of cells, strands, chains, solid formations, among immature connective tissue with low hyalinosis); «cell size (area, cm²)» - «severity of haemosiderosis» and «cell size (area, cm²)» - «the number of multinucleated giant cells» (there is a pronounced deposition of pigment and accumulation of osteoclast-like multinucleated giant cells type, although usually their number is relatively small compared to the localized type of TSGCT). Conclusions: Morphological parameters, that we have identified, characterize pathological changes in the tissues of TSGCT; careful analysis of the frequency of their occurrence in the different comparison groups made it possible to establish intergroup differences and correlations between individual indicators, which were previously unknown or not obvious. Our study was determine to analyze of incidence rates and correlation relationships, revealed some previously unknown differences and dependencies that are important for understanding the pathogenesis, improvement of diagnosis and prognosis of diffuse-type TSGCT.

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Giant Cell Poor Extra-Articular Diffuse-Type Tenosynovial Giant Cell Tumor With Extensive Desmin Expression: A Potential Diagnostic Pitfall With Cytogenetic Confirmation

International Journal of Surgical Pathology ◽

10.1177/1066896918788678 ◽

2018 ◽

Vol 27 (1) ◽

pp. 59-61

Author(s):

Liurka Lopez ◽

Karen Schoedel ◽

Ivy John

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Mononuclear Cells ◽

Giant Cells ◽

Cell Tumor ◽

Diffuse Type ◽

Tenosynovial Giant Cell Tumor ◽

Diagnostic Pitfall

Diffuse-type tenosynovial giant cell tumor can rarely present as an entirely extra-articular mass, which can be misdiagnosed as a sarcoma especially when giant cells are absent, dominated by large dendritic mononuclear cells, and desmin expression is extensive.

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Tenosynovial Giant Cell Tumor of Diffuse Type in Ankle and Foot - A Case Report

International Journal of Medicine and Public Health ◽

10.4103/2230-8598.108411 ◽

2012 ◽

Vol 2 (1) ◽

pp. 77

Author(s):

A Hakeem ◽

M Ibrahim ◽

A Qadri

Keyword(s):

Case Report ◽

Giant Cell Tumor ◽

Giant Cell ◽

Cell Tumor ◽

Diffuse Type ◽

Tenosynovial Giant Cell Tumor ◽

Ankle And Foot

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Abstract C087: Phase 1 study of DCC-3014, an oral inhibitor of CSF1R, to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics in patients with advanced solid tumors, including diffuse-type tenosynovial giant cell tumor

10.1158/1535-7163.targ-19-c087 ◽

2019 ◽

Author(s):

Matthew H Taylor ◽

Stephen Leong ◽

Ying Su ◽

Cynthia B Leary ◽

Xiaoyan Li ◽

...

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Solid Tumors ◽

Phase 1 ◽

Cell Tumor ◽

Advanced Solid Tumors ◽

Diffuse Type ◽

Pharmacokinetics And Pharmacodynamics ◽

Phase 1 Study ◽

Tenosynovial Giant Cell Tumor

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P05.33 Extra-articular tenosynovial giant cell tumor of diffuse type in the temporal area with brain parenchymal invasion

Neuro-Oncology ◽

10.1093/neuonc/noy139.359 ◽

2018 ◽

Vol 20 (suppl_3) ◽

pp. iii310-iii310

Author(s):

Y Park ◽

C Woo, M ◽

H Moon ◽

B Moon ◽

S You

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Cell Tumor ◽

Diffuse Type ◽

Temporal Area ◽

Tenosynovial Giant Cell Tumor ◽

Brain Parenchymal

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Tenosynovial giant cell tumor (TGCT)/pigmented villonodular synovitis (PVNS): Outcome of 313 patients before the era of kinase inhibitors.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.10022 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 10022-10022

Author(s):

Emanuela Palmerini ◽

Stefano Pengo ◽

Robert G. Maki ◽

Eric L. Staals ◽

Angela Cioffi ◽

...

Keyword(s):

Local Recurrence ◽

Giant Cell Tumor ◽

Giant Cell ◽

Kinase Inhibitors ◽

Benign Neoplasm ◽

Cell Tumor ◽

Cancer Center ◽

Tenosynovial Giant Cell Tumor ◽

Local Recurrences ◽

Resection Status

10022 Background: Tenosynovial giant cell tumor (TGCT) is a rare, usually benign neoplasm of synovium and tendon sheath. TGCT is classified as localized or diffuse according to the extent of synovial involvement. Surgery is the primary treatment, but the recurrence rate is high, with possible multiple recurrences, joint function deterioration and decline in quality of life. Recent data suggest a role for TKIs in advanced disease. In order to identify prognostic factors for recurrence, a retrospective pooled analysis was carried out in three institutions (Istituto Ortopedico Rizzoli, Bologna, Italy; Istituto Nazionale Tumori, Milano, Italy; Memorial Sloan Kettering Cancer Center, New York, USA). Methods: Clinical charts and pathology reports of patients (pts) treated in the period 1998-2008 were examined. Results: The study included 313 pts, 177 F and 136 M; median age: 36 years (range: 11-89 years). Most (64%) pts had tumors in the knee (15% ankle, 11% hip, 10% other). Tumor size was: <2 cm in 24% of pts, 2-5 cm in 44%, >5 cm in 32%. A diffuse pattern was reported in 69% of pts. The resection status was available in 289 pts: 51% had R0 surgery, 28% R1 and 21% R2. No metastases were documented. Local recurrence was reported in 76 pts (median time to recurrence: 15.7 months). With a median follow-up of 4.2 years, 5-year local recurrence-free survival (LRFS) was 66% (95% CI: 59 - 73). Size (< 2 cm 80% vs. 2-5 cm 67% vs. >5 cm 62%, p=0.04), gender (F 73% vs. M 56%, p=0.02), type (localized 78% vs. diffuse 61%, p=0.02), and resection status (R0 76% vs. R1 55%, vs. R2 57%, p=0.002) influenced 5-year LRFS, whereas age, tumor location and bone involvement did not. The 5-year 2nd LRFS was 43% (95% CI: 28 - 59). Multiple (2 to 5) local recurrences were observed in 39% of relapsed patients. Conclusions: The study confirms TGCT propensity to multiple local recurrences. Diffuse type, suboptimal surgery, male gender and larger tumors increase the recurrence risk. In order to improve the probability of local control, studies addressing the role of TKIs could be considered in subsets of patients.

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