Giant Cells Tumors of Synovial Sheaths of the Hand are Benign Tumors with a Good Prognosis

Abstract

Introduction: The giant cells tumors (GCT) of the hand are common benign tumors that pose a recurrence problem. The aim of our study is to analyze epidemiological and clinical data, evaluate results and determine the recurrence risk factors. Materials and Methods: This is a retrospective study of 50 patients operated between 2003 and 2015 for a (GCT) of the hand, we observed epidemiological data, clinical outcome (quotation TAM score Kapandji and quick DASH), the appearance of recurrence, the histological appearance, localization, excision margins and invasion of adjacent anatomical structures were analyzed. Results: We report a retrospective study over thirteen years of 50 cases of GCT of the hand, with a mean age of 42 years and a sex ratio of 1/3. The motive for consulting was the presence of a digital mass, followed by discomfort bending in 20%. Palmar localization was found in 54%, especially at the second ray (30%) and facing the distal phalanx (38%). The radiograph showed soft tissue opacity in 60% of cases. All patients underwent surgery, the macroscopic appearance showed an encapsulated, lobed and yellow chamois tumor in 80% of cases. The mean follow up was 30 months with extremes of 2 months to 10 years. We noted 5 recurrences one of which recurred twice; the average time to recurrence was 22 months and ranged from 6 months to 36 years. In each subsequent offense we noted an intra-articular tumor development in 4 cases and tendon erosion in one case. Functional complications type of stiffness in flexion in 2 cases and hypoesthesia of a finger in 2 cases. The quick way DASH was 2.2 on 100. Conclusion: The GCT of synovial sheaths of the hand are a benign tumors with a good prognosis, the main problem is the risk of recurrence that depends on the type of tumor, intra articular tumor development and quality of tumor resection.