scholarly journals Giant Cell Tumor of Phalanx – An Unusual Site

Author(s):  
Deepika Phogat ◽  
Shavinder Dogra ◽  
Swayam Tara ◽  
Suresh Suthari ◽  
Vineet Vij

Giant Cell Tumor (GCT) is a locally aggressive bone tumor typically affecting the ends of long bones with fewer than 5% of cases involving the tubular bones of the hands and feet. At these rare sites, other differential diagnosis have to be considered and ruled out based upon the clinical, radiological and histopathological findings. We came across a case of giant cell tumor of the base of proximal phalanx of index finger in a 34-year-old male in whom the clinical presentation, radiological finding and most importantly the key features on histopathological examination helped us clinch this rare diagnosis. Through this case we understood the importance of differentiating features of GCT from other giant cell lesions of bone that form the basis of the final diagnosis, that is crucial in order to decide the line of management.

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Shahaji Chavan ◽  
Shyamsunder Shambhu Sable ◽  
Sachin Tekade ◽  
Prashant Punia

Tuberculosis (TB) is still endemic in many developed countries. Involvement of the hand and wrist at presentation is extremely rare, and the diagnosis is often missed. A 57 years old male presented with swelling over the left wrist since 3 years Three swellings over dorsal aspect of the left wrist Soft in consistency Non tender Non compressible Mobile at right angles to the plane of the wrist joint. ESR: 45 mm in 1 hr and rest blood investigations were normal. Ultrsonography showed giant cell tumor of Extensor Digitorum sheath. X-ray: soft tissue swelling and MRI was suggestive of extensor tendon sheath extraskeletal synovial Koch’s, or giant cell tumor of tendon sheath. Excision of swelling was planned and intraoperatively, rice bodies were seen inside it. Histopathological examination showed caseous necrosis with granuloma formation. Patient was put on DOT1 therapy. Tuberculous tenosynovitis was first described by Acrel in 1777. Rice bodies occurring in joints affected by tuberculosis were first described in 1895 by Reise. Rice bodies will be diagnosed on plain radiographs when mineralization occurs. More than 50% of cases recur within 1 year of treatment. The currently recommended 6-month course is often adequate with extensive curettage lavage and synovectomy should be performed. Surgery is essential, but the extent of surgical debridement is still debatable. The surgeon has to be aware of the significance of loose bodies when performing routine excision of innocuous looking wrist ganglia.


2018 ◽  
Vol 1 (Supplement) ◽  
pp. 44
Author(s):  
A.M. Bratu ◽  
I.A. Sălcianu ◽  
A.I. Nicula ◽  
C. Zaharia ◽  
A.N. Marinescu

Abstract Giant cell tumor of soft tissue (GCTST) is usually of synovial origin. It affects synovial membrane, serous bursae, and tendinous tunnels. The most common localizations are in the hands and forearms. Anatomopathological, GCTST is considered as being composed of a cellular fibroblastic stroma in which the tumor cells are distributed. This type of tumor is composed of a mononuclear complex and osteoclast-like giant multinucleated cells, similar to those found in the giant cell tumor at the bone level. Histologically, some authors consider that GCTST is a strictly benign tumor, consisting of welldefined multinucleated histiocytes admixed with eosinophils, lymphocytes and scattered spindleshaped cells, or hemosiderin deposits in its structure, and tumor cells do not have mitosis or atypia. Other authors consider that GCTST is a type of low-grade sarcoma; this entity was named “malignant fibrous histiocytoma, giant cell type” due to the histological similarity with malignant fibrous histiocytoma. The case of a female patient, suspected of giant cell tumor of the brachioradialis tendon sheath was presented. The MRI aspect of this tumor is not the typical one. The MRI examination consisted of a series of sequences, with T1 and T2 weighted images, fat suppression sequence, performed in all three planes, axial, sagittal, and coronal. Also, the examination was performed native, after the administration of intravenous contrast substance, when the 3D multiplanar sequences were performed. The final diagnosis was the post-operative anatomopathological examination, which confirmed that it was a giant cell tumor. We present this case for its less frequent localization - forearm, and the interest it might have in surgical treatment.


2011 ◽  
Vol 46 (2) ◽  
pp. 205-210
Author(s):  
Frederico Carvalho de Medeiros ◽  
Fernando Carvalho de Medeiros ◽  
Izabella de Campos Carvalho Lopes ◽  
Guilherme Carvalho de Medeiros ◽  
Eduardo Carvalho de Medeiros

2008 ◽  
Vol 121 (1) ◽  
pp. 354-355 ◽  
Author(s):  
Kohei Kanaya ◽  
Takuro Wada ◽  
Kumiko Kitajima ◽  
Toshihiko Yamashita

2021 ◽  
Vol 11 (9) ◽  
Author(s):  
T V Raj Guhan ◽  
R V Raghav ◽  
M Mohan Kumar ◽  
Pravin K Vanchi

Introduction: Giant cell tumor (GCT) most commonly involves distal femoral condyles, distal end of radius, proximal tibial plateau, and proximal humerus. GCT is uncommon to occur in small bones of hand and feet. 2% of GCT occur in hand. The incidence of GCT in foot is 1.2–1.8%. Only a few cases have been reported in literature worldwide. GCT is the most common cause of secondary ABC. We report a case of GCT of intermediate cuneiform in a 25-year-old female evolving into aneurysmal bone cyst (ABC). Case Report: A 25-year-old female presented to us with complaints of pain and swelling over the dorsum of right foot for a period of 1 year. On examination, there was a localized ovoid-shaped swelling of 2 by 2 cm over the dorsum of right foot. Radiographs revealed a well-defined osteolytic lesion in the intermediate cuneiform. T2 MRI showed hyper-intense lesion in intermediate cuneiform. The patient was taken up for surgery, and the intermediate cuneiform was excised completely. Removed bone was sent for histopathological examination which confirmed it to be GCT evolving into secondary ABC. The patient was followed for 1 year and had no complaints. The patient was able to weight bear and walk without any difficulty. There was no recurrence of lesion. Conclusion: GCT of the cuneiform evolving into ABC is a very rare presentation. The treatment of choice is excision of the tumor with or without bone grafting. Any osteolytic lesion in the small bones must be evaluated and should be intervened in the early stage. Keywords: Giant cell tumor, osteolytic lesion, surgical resection, intermediate cuneiform.


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