Giant cell tumour of the flexor tendon sheath of the hand: analysis of 27 cases

Abstract

Giant cell tumour of the tendon sheath (GCTTS) is a slowly progressing benign tumour arising from synovial cells of tendon sheaths. It is one of the most common soft tissue tumours in the hand. We report a retrospective study of 27 proven GCTTS of the hand. The mean length of follow-up was 4.5 years (17 months-8.5 years). Radiographic findings are useful and may prove of great diagnostic value. The positive diagnosis was provided by the pathology examination after complete excision that was performed in all patients. The recurrence was noted in two surgically managed cases. The excision should be meticulous and complete in order to avoid recurrence.

Giant Cell Tumor of Tendon Sheath of the Hand: Experience With Forty-Seven Cases

“…In other studies, some differences in term of age distribution were reported, but in many of them, patients were at any age with a peak involvement at third to fifth decades of life (1,5,6,11). Similar to previous studies, our patients were at any age and most of them were in fourth decade of their life (34%).…”

“…The GCTTS of the hand is a painless slow-growing mass and many patients only complain of a swelling mass more often located at the palmar surface (1,2,4,10,11,14). In current study, none of the patients had explained pain.…”

“…Several risk factors have been reported to increase the risk of GCTTS recurrence including adjacent degenerative joint, proximity to distal interphalangeal joints of fingers and interphalangeal joint of the thumb, radiologic osseous erosion, and some histopathologic findings such as types of cells, increased cellularity or mitotic activity, capsular involvement, and 23-nm negativity (1,2,11,14). Recently, Al-Qattan et al demonstrated that the risk of recurrence is greater in tumors surrounded by pseudocapsule (1).…”

“…In addition, abnormal lipid metabolism has been suggested to be involved in GCTTS (1,2). Despite the benign nature, local recurrence after excision, with the rate of 4.2% to 28.6%, has been widely reported (1,2,(4)(5)(6)(10)(11)(12). Although radiotherapy can reduce the rate of recurrence (4), recurrent tumors have remained a challenging problem for the hand surgeons.…”

Comparison of Ultrasonography and Magnetic Resonance Imaging for Diagnosis of Soft Tissue Masses of the Hand and Wrist

“…It is the second most common lesion of the hand and wrist (6,8,9,11). And also, it is the most common soft tissue tumor of the hand and wrist (1,12). Middleton et al defined ultrasonographic appearance of these tumors as hypoechoic and mostly homogenous (11).…”