Giant cell tumor of the tendon sheath: Magnetic resonance imaging findings in 38 patients

Abstract

Abstract. The present study aimed to investigate the value of magnetic resonance imaging (MRI) in the diagnosis of giant cell tumor of the tendon sheath (GCTTS), including localized (L-) and diffuse (D-) types. A total of 38 patients with GCTTS, including 31 with L-GCTTS and 7 with D-GCTTS, diagnosed by surgery and pathology, were retrospectively analyzed. All patients underwent MRI examination. Of the 31 patients with L-GCTTS, the tumors were located in the hand and wrist (18 patients), the ankle and foot (10 cases), the knee joint (2 cases) and the temporomandibular joint (1 case). All 31 lesions were either located in relation to a tendon or were partially/completely enveloping it and all were well marginated. With respect to the 7 D-GCTTS patients, the tumors were located in the ankle and foot (6 cases) or the hand and wrist (1 cases). All 7 lesions presented as an aggressive soft tissue mass infiltrating the tendon sheath and adipose tissue around the joint. The characteristic internal signal of GCTTS, including L-GCTTS and D-GCTTS, was demonstrated by MRI examination. MRI is currently the optimal modality for preoperative assessment of tumor size, extent and invasion of adjacent joint and tenosynovial space.

Recurrent pigmented villonodular synovitis of the temporomandibular joint

“…Classically, MRI depicts scattered foci of low signal on T1- and T2-weighted images because of hemosiderin deposition with or without an incomplete fibrous capsule [5] . A reactive joint effusion may be present and often demonstrates intermediate signal on T1-weighted imaging and high signal on T2-weighted imaging.…”

“…If enhancement is observed, it is usually caused by inflammation and increased vascularity of the synovium. More often, delayed enhancement of the solid component is observed [5] , [6] . Although these features are classic for PVNS on imaging, it should be noted that cases present with variable signal intensity depending on the degree of hemosiderin deposition.…”

A Pilot Evaluation of Magnetic Resonance Imaging Characteristics Seen With Primary Soft Tissue Giant Cell Tumor in 2 patients

“…The MRI appearance of the NF is more variable. Emphasis is placed on the differential diagnosis of these giant cell-rich soft tissue neoplasms because clinical behavior, prognosis, and treatment can significantly differ [15][16][17][18][19][20][21][22] .…”

T2-weighted Hypointense Tumors and Tumor-like Lesions

“…A diffuse type of GCTTS was described in older individuals and tends to have more hemosiderin and more aggressive appearances on MRI; thus it is often confused with a malignant soft tissue tumor. 38 Hemophilic arthropathy (HA), a type of siderotic synovitis, is due to cyclical episodes of hemarthroses in male patients with X-linked deficiency of coagulation factors. Blood products incite inflammatory thickening of the synovium, hemosiderin deposition, and secondary cartilage destruction.…”