Giant Cell Tumor of the Patellar Tendon Sheath: A Rare Case of Anterior Knee Pain

Abstract

Giant cell tumor of the tendon sheath (GCTTS) is a benign, proliferative lesion of the synovium of the joint, the bursa, and the tendon sheath. We report a case of intra-articular, localized GCTTS arising from the patellar tendon, which is a rare cause of anterior knee pain. The diagnosis may be delayed due to non-specific symptoms and normal plain radiographic findings. Magnetic resonance imaging (MRI) is diagnostic to detect the lesion, but several other clinical entities and lesions should be evaluated in the differential diagnosis. The treatment of choice is a total excision of the lesion without leaving residual tumor tissue, in order to reduce the risk of recurrence. We present a patient with GCTTS of the patellar tendon and discuss its clinical and radiographic characteristics, differential diagnosis, pathology, and treatment.

Unusual Occurrence of Tenosynovial Giant Cell Tumor in Hoffa's Fat Pad: A Potential Differential Diagnosis for Nontraumatic Knee Swelling and Pain

“…The presence of TGCT in Hoffa's fat pad is a very rare finding [4]. TGCT is usually seen in the age group of 30 to 50 years and more commonly in women, and our patient was a 33-year-old woman [1].…”

“…Due to nonspecific signs and symptoms, diagnosis of a giant cell tumor can be delayed for weeks or months. The common concerns may include painless or painful palpable swelling, joint effusion, locking of the knee joint, and restriction of movement [1,7,8].…”

“…The size of the tumor in this patient was 5 cm at its largest dimension. Only a few cases of a large tumor of this size (in the infrapatellar region) have been reported in the literature [1,3,7,9]. Panagopoulos et al reported a case of a giant cell tumor measuring 5 cm [8].…”

“…A tenosynovial giant cell tumor (TGCT) is a benign lesion of the tendon sheath, synovial membrane, or bursa [1]. It manifests in two forms, consisting of a localized form that involves an area of tendon sheath or synovial membrane, whereas the diffuse form is extensively involved with the synovium [2,3].…”

Localized Giant Cell Tumor of the Tendon Sheath: A Rare Case of Anterior Knee Pain

“…Residual tumors are the main cause of recurrence. Therefore, Kilicaslan et al [9] reported that they were more inclined to open surgery to remove the lesion without leaving any residue tissue. However, I recommend arthroscopic resection, because during the arthroscopic operation the image is enlarged, the removal is more comprehensive, with a small trauma and is easy to recover after surgery.…”