Rare site giant cell tumors: report of two cases on phalanges of the finger and review of literature

Double central ray amputation of the third and fourth digits for recurrent giant cell tumors of the hand: A case report

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Recurrent giant cell tumor of bone of hand treated by double central ray amputation.

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Double central ray amputation results in acceptable functional outcome of the hand.

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Double ray amputation aims to decrease re-recurrence rates of recurrent GCT of hand.

Introduction and importance

Recurrent giant cell tumor of the bone (GCTB) of the hand is very rare to be encountered. Our aim is to alert the surgeons to such condition and double central ray amputation of the third and fourth digits could be an option which may reduce the chance of a re-recurrence and provide an acceptable functional outcome.

Case presentation

We presented a 25-year-old woman with a recurrent GCTB of the proximal phalanx of the middle finger of the right hand. Considering the recurrent case, a high suspicion of malignancy, and apparent soft tissue extension, the lesion was treated with double central ray amputation of the third and fourth digits through metacarpals.

Clinical discussion

Extraosseous soft tissue invasion of recurrent GCTB of the hand had an important role in the treatment recommendation. A balance must be considered between the risk of re-recurrence and the impact of radical resection on function. Double central ray amputation surgery was performed in order to decrease the risk of additional recurrences. Acceptable functionality of the hand as she scored 26/30 (86 % rating) evaluated by Musculoskeletal Tumor Society (MSTS) Scoring System and no signs of local re-recurrence were found for 6 months follow up.

Conclusion

Double central ray amputation of the third and fourth digits is a good option for management of recurrent GCTB of proximal phalanx of the third digits with gross soft tissue extension to adjacent fourth digits region.

Recurrent Adolescent Giant-Cell Tumor of the Scaphoid: Scaphoid Excision with Intracarpal Fusion after Failed Curettage and Bone Grafting

We present a case of the giant-cell tumor of bone in the scaphoid of a 17-year-old female. Imaging revealed an expansile lytic lesion of her scaphoid, and the diagnosis was confirmed with open biopsy. She was treated with curettage and iliac crest bone graft, in an effort to spare reconstruction of her wrist. After one year, she developed increasing tightness and pain. Local recurrence was apparent on radiographs, and CT revealed increased lucency with bony destruction in the area of prior excision. She was successfully treated, without recurrence to date, with complete scaphoid excision and a four-corner wrist fusion. Local recurrence of the giant-cell tumor of bone is high, especially in carpal bones. When treating patients with advanced lesions, more aggressive initial options should be considered.

Reconstruction with fibular autograft and silicone implant arthroplasty after resection of giant-cell tumour of the proximal phalanx: a case report with 18-month follow-up

Primary giant-cell tumour of phalanx is a rare entity. Only few cases are described in the literature. Giant-cell tumour of hand is reported to have high local recurrence rate. Curettage and bone grafting have been performed by few authors with limited success. Most of the cases have been treated with ray amputation. We report this case as the first reported case in the literature that has been treated with fibular autograft and silicone implant arthroplasty for giant-cell tumour of the proximal phalanx.

A swollen middle finger in a middle-aged farmer

Hand tumors are not common and a swollen finger poses considerable diagnostic dilemma. We present a case of a middle-aged farmer who had presented with a painless swelling of the middle finger of the right hand without any neurovascular deficit or evidence of metastasis. An X-ray of the finger showed cortical expansion and bony erosion of the proximal phalanx. A fine needle aspiration cytological examination was inconclusive. He underwent a digit amputation in view of subsequent morbidity and chances of recurrence following local excision. Biopsy proved it to be a giant cell tumor of the proximal phalanx. Following six months of treatment he is doing well. We herein highlight an unusual tumor of the finger and its diagnostic and treatment challenges.

GCT of proximal phalanx of ring finger: a case report

Giant-cell tumor (GCT) of bone arising from phalanx of a finger is extremely rare. Rizzoli Orthopedic Institute in their study on 900 treated cases of GCT from 1947-1997 reported only 0.9% incidence of GCT in bones of the hand. There was no case of GCT of the phalanges in that series. We report here a case of GCT of bone arising from phalanx of finger because of its very unusual location. The tumor was diagnosed on the basis of fine-needle aspiration cytology and confirmed by histopathology.