Giant Cell Tumor on Tendon Sheath of the Hand: The Incidence of Recurrence, Functional Outcomes and a Literature Review

Giant Cell Tumor on Tendon Sheath (GCTTS) of the hand is a benign nodular tumor originated from tendon sheath of the tendons and the joints and is the second most common soft tissue tumor of the hand after ganglion cyst. The aim of this study is to evaluate 79 cases of giant cell tumor of tendon sheath of the hand and to analyze the postoperative functional outcomes and recurrence rate of the tumor in a mean period of five years follow up. Material and Methods: Fifty five subjects were females and twenty four males with an average age of 38,8 years-old (range23-65 years old) were included in this study. The most frequent location of tumor was the index finger (32/79 patients, 40,5%). The majority of patients was presented in outpatient’s clinic for a painless swelling on volar side of the digit, while only 13(16,45%) patients presented for painful mass and numbness of the digit in 7(8,9%) cases. All cases were categorized by Al-Qattan classification system with type I lesion in 51(64,5 %) cases and type II in 28(35,5 %) cases. Dimension of tumors macroscopically varied from 0,4cm to 5 cm. In 12 cases we reconstructed the A2 pulley to avoid bowstring deformity and eventual postoperative loss of hand function. In 12 cases we reconstructed the A2 pulley to avoid bowstring deformity and eventual postoperative loss of hand function. 8 patents with bone erosion underwent postoperatively complementary local radiotherapy. A standard protocol of rehabilitation was performed in all patients. Results: Results were evaluated according to complications, range of motion, Quick Dash Score and functional satisfaction of patients in a mean follow-up of 49 months. Two major complications presented in this study: 5 cases with transitional neuroapraxia and 6 cases with recurrence of the tumor with a mean of postsurgical period 14,8 months. Finally at last assessment the mean Quick Dash Score was 4,5 (range from 0-11,4) the range of motion was fully recovered in 73 patients while patient’s satisfaction rated from “very satisfied” in 58(73,4%) cases, “satisfied” in 17(21,5) and “dissatisfied” in 4(5,1%) patients. Conclusions: Giant cell tumor of tendon sheath of the hand is a common tumor which presents a high incidence of recurrence in different populations of patients. The goal of treatment is to reduce the recurrence rate and restore a functional hand. The operation procedure should be well planned preoperatively, the tumor must excised en block, dissection must be under surgical loop and must be emphasized to remove satellite lesion while when patients present increased risk factors or inadequate excision of the mass, postoperative radiotherapy is performed.

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GIANT CELL TUMOR OF TENDON SHEATH MIMICKING PYOGENIC GRANULOMA IN THE INDEX FINGER PULP: A CASE REPORT

Hand Surgery ◽

10.1142/s0218810412720124 ◽

2012 ◽

Vol 17 (01) ◽

pp. 125-127

Author(s):

J. Terrence Jose Jerome ◽

Kumar Venkatesan ◽

Amarnath G ◽

Usha Rani ◽

Rohini Sridhar

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Clinical Presentation ◽

Index Finger ◽

Pyogenic Granuloma ◽

Tendon Sheath ◽

Cell Tumor ◽

Complete Excision ◽

Study Base

We report a 75-year-old man who presented with a painless friable mass in the index finger pulp mimicking pyogenic granuloma. Complete excision of the mass was done. The radiological and the histopathological findings suggested giant cell tumor of the tendon sheath. The patient had no recurrence at the end of a two-year follow-up. This unusual clinical presentation of the giant cell tumor of the tendon sheath was our study base and adds up to its variant presentation in the literature.

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Giant Cell Tumor of the Tendon Sheath Around the Foot and Ankle

Journal of the American Podiatric Medical Association ◽

10.7547/0003-0538-105.3.249 ◽

2015 ◽

Vol 105 (3) ◽

pp. 249-254 ◽

Cited By ~ 9

Author(s):

Gauresh Vargaonkar ◽

Vikramadittya Singh ◽

Sumit Arora ◽

Abhishek Kashyap ◽

Vikas Gupta ◽

...

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Surgical Excision ◽

Tendon Sheath ◽

Cell Tumor ◽

Flexor Hallucis Longus ◽

Rare Clinical Entity ◽

Foot And Ankle ◽

Peroneus Brevis

The foot and ankle are rare sites of involvement for giant cell tumor of tendon sheath. We present three rare cases of giant cell tumor of tendon sheath arising from the tendon sheaths of the flexor hallucis longus, peroneus brevis, and extensor hallucis brevis tendons, along with a literature review of such cases in the foot and ankle region. All of the patients were treated with surgical excision of the mass and were asymptomatic after minimum follow-up of 18 months. Giant cell tumor of tendon sheath involving the foot and ankle region is a rare clinical entity, and good results can be expected after surgical excision.

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Giant cell tumor of distal radius treated with ulnar translocation and wrist arthrodesis

Journal of Orthopaedic Surgery ◽

10.1177/2309499016684972 ◽

2017 ◽

Vol 25 (1) ◽

pp. 230949901668497 ◽

Cited By ~ 6

Author(s):

Abhijeet Ashok Salunke ◽

Jaymin Shah ◽

Vikas Warikoo ◽

Amit Chakraborty ◽

Harshwardhan Pokharkar ◽

...

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Distal Radius ◽

Functional Outcomes ◽

Soft Tissues ◽

Cell Tumor ◽

Musculoskeletal Tumor Society ◽

Wrist Arthrodesis ◽

The Mean

Introduction: The aim is to analyze the functional outcomes of patients of giant cell tumor (GCT) of distal radius treated with ulnar translocation and wrist arthrodesis. Methods: Study included 25 patients of aggressive GCT of distal radius, resected and reconstructed using ulnar translocation and wrist arthrodesis. The ulna-carpal radius fixation was performed with plate and screws. The patients were followed to bony union and minimum follow-up was 1 year. Result: Twenty-two patients were of Campanacci grade 3 and three patients were of Campanacci grade2. The mean follow-up was of 23 months (12–36). All patients had an excellent range of pronation and supination. The mean Musculoskeletal Tumor Society score was 24 (range 22–28). Grip strength of affected hand compared to the contra lateral hand was found good in 17 cases and average in 7 cases. The mean bone union time at ulna to radius junction was at 6.5 (5–8) months and ulna to carpal junction at 4.5 (4–6) months. The complications were surgical site infection (one case), recurrence (one case) and failure of union (one case), and ulna graft fracture with implant failure in (two cases). Conclusion: Reconstruction of distal end of radius using ulnar translocation and wrist arthrodesis provides excellent functional outcomes with preservation of rotational movement of forearm and hand function. Reconstruction of the distal radius by ulnar translocation without complete detachment from surrounding soft tissues functions like vascularized graft without use of microvascular techniques.

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Functional Outcomes of Limb Salvage Surgery in Patients with Giant Cell Tumor of Bone of the Lower Extremities: A Retrospective Study

Journal of Oncology Research ◽

10.30564/jor.v3i2.3669 ◽

2021 ◽

Vol 3 (2) ◽

Author(s):

Daniela Kristina D. Carolino ◽

Edwin Joseph R. Guerzon ◽

Richard S. Rotor

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Limb Salvage ◽

Functional Outcomes ◽

Salvage Surgery ◽

Lower Extremities ◽

Cell Tumor ◽

Limb Salvage Surgery ◽

Msts Score

Giant cell tumor of the bone (GCTB) is a benign, locally aggressive neoplasm that is relatively rare, with a propensity to result in progressive bone destruction, and is associated with a high risk of recurrence. There is no widely held consensus regarding its ideal treatment. Worldwide, there are varying techniques ranging from intralesional curettage to resection of the lesion, supplemented with combinations of numerous adjuncts and fillers, depending on the resected amount and integrity of bone, as well as the preference of the surgeon. This was a cross-sectional study that included 20 patients who underwent limb salvage surgery for giant cell tumor of the bone of the lower extremities from January 2009 to February 2020 at two tertiary hospitals. The mean follow-up period was 37.3 months (SD=2.84). The extended curettage (EC) group had a mean Musculoskeletal Tumor Rating Scale (MSTS) score of 28.18 (SD=7.51) which is considered as an excellent outcome, while the resection (RS) group had an mean MSTS score of 19.67 (SD=11.02), which is considered as a good outcome. EC resulted to a total of eight complications (47%), while RS had one complication (33%). Prevalence of recurrence was noted to be 11.75% among those who underwent EC, while no recurrence was noted among those in the RS group. Use of bone cement as a filler was noted to have less recurrence as compared with the use of bone grafts, however were both were noted to result in excellent functional outcomes. Despite the prevalence of complications and recurrence of GCTB of the salvaged extremity in those who underwent EC, there is still report of excellent functionality. It is hence important to disclose all these possible outcomes and to stress the importance of compliance to follow-up for monitoring of these events.

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Giant cell tumor of tendon sheath in the hand: analysis of risk factors for recurrence in 50 cases

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2866-8 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 4

Author(s):

Hakan Ozben ◽

Tamer Coskun

Keyword(s):

Risk Factors ◽

Giant Cell Tumor ◽

Giant Cell ◽

Tendon Sheath ◽

Cell Tumor ◽

Resonance Imaging ◽

Recurrence Rates ◽

Standardized Treatment ◽

Risk Factors For Recurrence

Abstract Background Giant cell tumor of the tendon sheath is the most common form of giant cell tumors and is the second most common soft tissue tumor of the hand region after ganglion cyst. Magnetic resonance imaging is the diagnostic tool of choice for both diagnosis and treatment planning. The current standard treatment of choice is simple excision. The main concern about the treatment is related to the high recurrence rates. Besides incomplete excision, there is no consensus concerning the effect of other risk factors on recurrence. The literature lacks detailed reports on surgical excision of these tumors with a standardized surgical treatment and an appropriate patient follow up. The aim of this study was to investigate the recurrence rate and the associated recurrence risk factors for giant cell tumor of tendon sheath of the hand following a standardized treatment. Methods The records of patients treated for giant cell tumor of tendon sheath of the hand treated by the same hand surgeon were evaluated retrospectively. The features obtained from preoperative magnetic resonance imaging, final physical examination, patients’ age and sex, anatomical site of the tumor, relationship of the tumor with bone, joint or neurovascular structures, bone invasion, recurrence after surgery and complications like skin necrosis, digital neuropathy or limitation in range of motion were documented. Chi-square test was used to compare categorical variables. Results Fifty patient were included in the study. The average follow-up time was 84 months. Three recurrences (6%) were recorded. The only significant risk factor for the recurrence was tumor adjacency to the interphalangeal joints of the fingers other than thumb. No major or minor complications were encountered in the postoperative period. Conclusion With adequate surgical exposure and meticulous dissection provided by the magnification loupes, we were able demonstrate one of the lowest recurrence rates in the literature. Well-designed studies combining the recurrence rates of several hand surgery centers implementing a standardized treatment are needed to better demonstrate the associated risk factors for recurrence.

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Giant Cell Tumor of Tendon Sheath with Tarsal Bones and Intertarsal Joint Invasion: A Case Report

Journal of the American Podiatric Medical Association ◽

10.7547/19-059 ◽

2020 ◽

Vol 110 (3) ◽

Author(s):

Qi-Fang He ◽

Zhen-Yu Bian ◽

Jing-Jing Xiang ◽

Liu-Long Zhu

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Benign Lesion ◽

Surgical Excision ◽

Tendon Sheath ◽

Cell Tumor ◽

Tarsal Bones ◽

Intertarsal Joint ◽

Tomography Scan

The giant cell tumor of tendon sheath (GCTTS) is a benign lesion most commonly attached to the tendons and bones of the fingers, hands, and wrists. The involvement of GCTTS to the foot is uncommon. The GCTTS invading tarsal bones and intertarsal joints is not described yet, and the appropriate diagnosis and treatment remain unclear. We report a case of GCTTS with the involvement of tarsal bones and intertarsal joint. Computed tomography scan and magnetic resonance imaging were used to further diagnose and evaluate the quality and range of tumor. The patient was treated with surgical excision of the tumor without application of bone graft. After adequate clearance of the tumor, the patient returned to an asymptomatic walk in 3 months. No malfunction, fracture, or tumor recurrence was found in 2-years follow-up. This report includes clinical, radiologic, histologic diagnostic, and surgical challenges in an unexpected lesion and a review of the literature.

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Giant cell tumor of tendon sheath in the wrist that damaged the extensor indicis proprius tendon: a case report and literature review

BMC Cancer ◽

10.1186/s12885-019-6293-x ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Qingfang Zhao ◽

Hui Lu

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Histopathological Examination ◽

Surgical Excision ◽

Tendon Sheath ◽

Cell Tumor ◽

Case Presentation ◽

Extensor Indicis Proprius ◽

History Of

Abstract Background Giant cell tumor of the tendon sheath (GCTTS) is a benign soft tissue (synovial membrane) tumor that rarely involves the hands or wrists. And Tendon impairment caused by GCTTS is extremely rare. Case presentation Here, we reported a case of a 60-year-old female with a 10-year history of gradually increasing mass in her left dorsal wrist. The EIP tendon was partially impaired by the mass.The patient was treated with surgical excision of the mass and reconstruction of the EIP tendon. The histopathological examination suggested the presence of GCTTS. After surgery, the patient had adequate functional recovery and no tumor recurrence after 2 years’ follow-up. Conclusion GCTTS in hands and wrists rarely damages the tendon. Early diagnosis and proactive interventions may likely contribute to good prognostic outcomes.

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Giant cell tumor of tendon sheath

International Surgery Journal ◽

10.18203/2349-2902.isj20174909 ◽

2017 ◽

Vol 4 (11) ◽

pp. 3785

Author(s):

Abhishek Singh ◽

Nagendra Yadav ◽

Bharat Bhushan Dogra ◽

Ashutosh Singh

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Local Excision ◽

Inflammatory Process ◽

Ring Finger ◽

Tendon Sheath ◽

Cell Tumor ◽

Chronic Antigenic Stimulation ◽

Common Benign Tumour

Giant Cell Tumor of Tendon Sheath (GCTTS) is the second most common benign tumour affecting hand after ganglion. The tumor generally affects individuals between the age of 30 and 50 years, and is found more often in women than men. The etiological factors responsible for GCTTS are unclear. Some authors consider it as an inflammatory process arising as a consequence of chronic antigenic stimulation. Local excision with or without radiotherapy is the treatment of choice. We recently encountered two cases of Giant cell tumor involving tendon sheath of ring finger in one case and thumb in another case. Both were managed surgically with good results. There has been no evidence of recurrence till date in the follow up varying from 3-6 months.

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