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Bakota-Morrison C, Strasser R, Letovanec I, Digklia A, Stamatiou A, Omoumi P, Cherix S. [Diagnosis and management of tenosynovial giant cell tumor]. Rev Med Suisse 2023; 19:2330-2335. [PMID: 38088403 DOI: 10.53738/revmed.2023.19.854.2330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Tenosynovial giant cell tumor is a benign condition that originates from synovial cells within joints, tendon sheaths, or bursae and may present either in localized (benign) or diffuse (locally aggressive) forms. Currently, the primary treatment approach is surgical, yielding satisfactory results with low recurrence rates in the localized forms, whereas the diffuse type displays high recurrence rates. In parallel, clinical trials are underway to explore pharmaceutical treatment options for the advanced diffuse type. This article aims at consolidating current knowledge about diagnosis and management of this rare tumor, additionally proposing a brief overview of novel therapeutic approaches.
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Affiliation(s)
- Canelle Bakota-Morrison
- Service d'orthopédie et traumatologie, Département de l'appareil locomoteur, Centre des sarcomes, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Roland Strasser
- Service d'orthopédie et traumatologie, Département de l'appareil locomoteur, Centre des sarcomes, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Igor Letovanec
- Institut universitaire de pathologie, Centre des sarcomes, Centre hospitalier universitaire vaudois, 1011 Lausanne
- Service d'histocytopathologie, Institut central, Hôpital du Valais, 1951 Sion
| | - Antonia Digklia
- Service d'oncologie médicale, Département d'oncologie, Centre des sarcomes, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Antonia Stamatiou
- Service d'oncologie médicale, Département d'oncologie, Centre des sarcomes, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Patrick Omoumi
- Service de radiodiagnostic et radiologie interventionnelle, Département de radiologie médicale, Centre des sarcomes, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Stéphane Cherix
- Service d'orthopédie et traumatologie, Département de l'appareil locomoteur, Centre des sarcomes, Centre hospitalier universitaire vaudois, 1011 Lausanne
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Ben Hamouda M, Soua Y, Achour A, Abdejlil N, Korbi M, Lahouel I, Youssef M, Belhadjali H, Zili J. A Mass on the Sole Revealing a Giant-Cell Tumor of the Tendon Sheath. Skinmed 2023; 21:280-281. [PMID: 37771023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
A 61-year-old woman presented with a 3-year history of painless soft-tissue mass on the right sole. The patient reported gradual growth, with a rapid increase in size over the past few months, leading to difficulty in walking. She had no history of past trauma. Examination revealed a 4-cm ovoid mass located over the ball of the foot. It was firm in consistency, with well-defined margins, a smooth surface, and an overlying normal skin (Figure 1). An ultrasound image revealed an eccentric, hypoechoic, nonvascular subcutaneous lobular mass. A magnetic resonance imaging (MRI) of the foot revealed a well-defined mass arising from the flexor tendon sheath of the right foot. The lesion was heterogeneously hyperin-tense on T1- and T2-weighted images with an avid contrast enhancement. All of the surrounding soft tissues indicated normal signal intensity patterns. There was no associated bony destruction. Histopathologic examination after complete excision of the mass established a well-circumscribed lesion composed of osteoclast-like giant cells and mononuclear cells in a hyalinized stroma, consistent with a giant cell tumor of the tendon sheath (GCT-TS) (Figure 2). There was no recurrence during a 6-month follow-up period (Figure 3).
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Affiliation(s)
- Mouna Ben Hamouda
- The Departments of Dermatology, Fattouma Bourguiba Hospital, Monastir, Tunisia;
| | - Yosra Soua
- The Departments of Dermatology, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Asma Achour
- Radiology, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Nouha Abdejlil
- Pathology, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Mouna Korbi
- The Departments of Dermatology, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Ines Lahouel
- The Departments of Dermatology, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Monia Youssef
- The Departments of Dermatology, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Hichem Belhadjali
- The Departments of Dermatology, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Jameleddine Zili
- The Departments of Dermatology, Fattouma Bourguiba Hospital, Monastir, Tunisia
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Tan-Garcia A, Tay TKY, Shi R, Yeo SJ, Sittampalam K. A hyalinised tenosynovial giant cell tumour with absence of giant cells posing a diagnostic challenge. Pathology 2023; 55:726-728. [PMID: 37080827 DOI: 10.1016/j.pathol.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/26/2022] [Accepted: 01/14/2023] [Indexed: 04/22/2023]
Affiliation(s)
- Alfonso Tan-Garcia
- Division of Pathology, Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Timothy Kwang Yong Tay
- Division of Pathology, Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Ruoyu Shi
- Division of Pathology, Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Seng Jin Yeo
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
| | - Kesavan Sittampalam
- Division of Pathology, Department of Anatomical Pathology, Singapore General Hospital, Singapore.
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Jaiswal A, Ambade R. Tenosynovial giant cell tumour of the finger: a case report. Pan Afr Med J 2023; 45:49. [PMID: 37575525 PMCID: PMC10422033 DOI: 10.11604/pamj.2023.45.49.37714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 05/05/2023] [Indexed: 08/15/2023] Open
Abstract
Giant cell tumour most commonly occuring in epiphysis of the long bone, present and with pain, tenderness and swelling. It is a solitary lesion with restricted movement and tenderness over the lesion. The tendon sheath is where tenosynovial giant cell tumours typically develop. Because of its remarkably peculiar position, we present a case of giant cell tumour (GCT) tenosynovial of bone in the middle phalaynx in a 33-year-old female with complaints of swelling, pain in ring finger of left hand since 2 months which is rarely seen. After clinical, radiological, pathological investigations tenosynovial giant cell tumour was diagnosed. Following fine needle aspiration cytology, histopathology was utilized to confirm the tumour's diagnosis which was later treated as resection of excision of the tumour with allo/autograft reconstruction. Our case report showed no evidence of recurrence in 2 years of follow-up. Hence our case report proves that early and complete resection of the tumour shows evidence of regain of complete range of motion and decrease recurrence rate.
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Affiliation(s)
- Ankit Jaiswal
- Department of Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, Maharashtra, India
| | - Ratnakar Ambade
- Department of Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, Maharashtra, India
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Huang CG, Li MZ, Wang SH, Tang XQ, Zhang HL, Haybaeck J, Yang ZH. Giant cell tumor of tendon sheath: A report of 216 cases. J Cutan Pathol 2023; 50:338-342. [PMID: 36287206 DOI: 10.1111/cup.14344] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND In this article on giant cell tumor of tendon sheath (GCTTS), we intend to summarize and analyze the clinical and pathological features of GCTTS hoping to improve clinical management and patient treatment. METHODS The study retrospectively reviewed 216 patients of GCTTS, registered at the Affiliated Hospital of Southwest Medical University from January 2010 to December 2020. These cases were diagnosed by surgical excision. The clinicopathological features and the prognosis were reviewed in the light of the current literature. RESULTS Of these 216 GCTTS patients, 72 were males (33.3%) and 144 females (66.7%), with a ratio male-to-female of 1:2. The patients' age ranged from 5 to 82, the average being 41.5 years at diagnosis. A total of 96 cases (44.4%) occurred in the hand region, followed by 35 cases (16.2%) in the knee, 32 cases (14.8%) in the foot, 25 cases (11.6%) in the ankle, 12 cases (5.6%) in the wrist, 12 cases (5.6%) in the leg, 2 cases (0.9%) in the head, 1 case (0.5%) in the forearm, and 1 case (0.5%) inside and outside the spinal channel. Histopathology mainly revealed large synovial-like monocytes, small monocytes, and osteoclast-like giant cells. CONCLUSION Our results confirm that GCTTS predominantly occurs in the hands of young women. Complete surgical resection with long-term follow-up is the preferred management.
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Affiliation(s)
- Cong-Gai Huang
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Meng-Ze Li
- Department of Orthopaedics, Luzhou Hospital of Traditional Chinese Medicine, Luzhou, China
| | - Shao-Hua Wang
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xiao-Qin Tang
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Hui-Ling Zhang
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Johannes Haybaeck
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
- Diagnostic and Research Center for Molecular BioMedicine, Institute of Pathology, Medical University Graz, Graz, Austria
| | - Zhi-Hui Yang
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Fuchs L, Saleh S, Ganot G, Oron A. [MULTIPLE GIANT CELL TUMOR OF TENDON SHEATH: A CASE REPORT OF THREE LESIONS ON THE SAME FLEXOR TENDON]. Harefuah 2022; 161:487-489. [PMID: 35979566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
We present a case report of a triple location Giant Cell Tumor of tendon sheath appearance on the same flexor tendon sheath of a single digit. There have been scarce descriptions of multiple Giant Cell Tumors of tendon sheath. Multiple tumors may predispose patients to a higher recurrence rate; therefore, recognition and treatment of this rare entity is important.
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Affiliation(s)
- Lee Fuchs
- Department of Orthopedic Surgery, Kaplan Medical Center, Rehovot, Israel
| | - Shadi Saleh
- Department of Orthopedic Surgery, Kaplan Medical Center, Rehovot, Israel
| | - Gil Ganot
- Department of Orthopedic Surgery, Kaplan Medical Center, Rehovot, Israel
| | - Amir Oron
- Department of Orthopedic Surgery, Kaplan Medical Center, Rehovot, Israel
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Abstract
Background: Benign soft-tissue tumors of the hand are more common than both their benign bone and malignant soft-tissue counterparts. This study evaluates the characteristics and treatment of benign soft tissue tumors in light of 1 institution's experience. Methods: Histologically confirmed benign soft-tissue tumors of the hand were retrospectively identified using International Classification of Disease codes from 1992 to 2015. A medical chart review was conducted to collect patient demographics, tumor epidemiology, and treatment. Results: A total of 199 soft-tissue tumors were identified. The median patient age at time of treatment was 47.4 ± 14.7 years in age. The majority of tumors were located in the digits (n = 168, 84%) and treated by excision (n = 191, 96%). Localized type tenosynovial giant cell tumors (n = 71, 36%) were the most common and had the highest rates of recurrence (8.5%) in this series. Other frequent histologies included hemangioma, schwannoma, and glomus tumors. Conclusion: Awareness and understanding of tumor characteristics may help physicians with diagnosis and treatment. There is an extensive variety of tumors, but the principles of clinical and imaging diagnosis are common to all of them. Marginal excision for the treatment pain, improvement of function, and cosmetic correction applies to all these tumors independent of the histology.
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Lee JK, Kwon YW, Shim JC, Kang YK, Cho WM, Park JW, Han SH. Similar appearance of different multifocal carpal bone destructing disease entities in 3 patients: A case report. Medicine (Baltimore) 2021; 100:e26445. [PMID: 34260526 PMCID: PMC8284703 DOI: 10.1097/md.0000000000026445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/07/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Several diseases feature tumors, or tumor-mimicking lesions, that further invade the bone and surrounding joints of the wrist region. Here, we describe 3 rare cases of multiple destructed carpal bones and adjacent joints in different disease entities confirmed via pathologic diagnosis. PATIENT CONCERNS All 3 cases were examined between January 2016 and December 2019. Three patients presented with similar clinical manifestations and radiographic features, with multiple osteolytic lesions in the carpal bones and metacarpal bone base. DIAGNOSES The 3 cases were diagnosed as diffuse type tenosynovial giant cell tumor, calcifying aponeurotic fibroma, and rheumatoid arthritis. INTERVENTIONS Separate, experienced radiologist and pathologist took part in the interpretation and compartmentalization of radiographs and pathological findings, respectively. Even magnetic resonance imaging could not achieve a diagnosis; surgical excision was therefore required, with subsequent pathological assessment for treatment and final diagnosis. OUTCOMES functional outcomes also differed among patients, poorest in rheumatoid arthritis patient. LESSONS We report 3 rare disease entities, presenting with multifocal osteolytic lesions in the wrist. They all presented with similar clinical manifestations, and the final diagnoses were made via pathological evaluation. Compared with tenosynovial giant cell tumor and calcifying aponeurotic fibroma, rheumatoid arthritis had the poorest outcome.
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Affiliation(s)
- Jun-Ku Lee
- Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Goyang
| | - Young Woo Kwon
- Department of Orthopedic Surgery, Uijeongbu Eulji Medical Center, Uijeongbu-si Gyeonggi-do
| | | | - Yun Kyung Kang
- Department of Pathology, Seoul Paik Hospital, Inje University College of Medicine, Seoul
| | - Weon Min Cho
- Department of Orthopedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do
| | - Jong Woong Park
- Department of Orthopedic Surgery, Korea University Anam Hospital, Seoul, South Korea
| | - Soo-Hong Han
- Department of Orthopedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do
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Thangaiah JJ, Koepplin JW, Folpe AL. RNAscope CSF1 chromogenic in situ hybridization: a potentially useful tool in the differential diagnosis of tenosynovial giant cell tumors. Hum Pathol 2021; 115:1-9. [PMID: 34058245 DOI: 10.1016/j.humpath.2021.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/20/2021] [Accepted: 05/20/2021] [Indexed: 01/15/2023]
Abstract
Colony stimulating factor-1 (CSF1) upregulation and CSF1/colony-stimulating factor 1 receptor (CSF1R) signaling pathway is central to the tumorigenesis of tenosynovial giant cell tumors (TGCT) of both localized (LTGCT) and diffuse (DTGCT) types, and has been demonstrated in a small number of malignant tumors (MTGCT) as well. In situ hybridization for CSF1 mRNA has been shown to be potentially useful in the diagnosis of TGCT, although only a relatively small number of cases have been studied. We studied CSF1 mRNA expression using RNAscope chromogenic in situ hybridization (CISH) in standard tissue sections from 31 TGCT and 26 non-TGCT, and in tumor microarray slides (Pantomics normal MN0341, Pantomics tumor MTU391, Pantomics melanoma MEL961). Among normal tissues, CSF1 mRNA expression was invariably present in synovium (10/10, 100%) and absent in all other normal tissues. All LTGCT and DTGCT were positive (24/24, 100%), exclusively in large, eosinophilic synoviocytes. MTGCT contained large clusters of CSF1-positive malignant synoviocytes (8/8, 100%); malignant spindled cells were also positive. Among non-TGCT, CSF1 CISH was less often positive with high specificity (90%). CSF1-positive cases included leiomyosarcoma, giant cell tumor of bone and of soft parts, pulmonary carcinoma and others. The sensitivity and specificity of RNAscope CSF1 mRNA CISH for the diagnosis of TGCT were 100% and 90%, respectively. We conclude that RNAscope CSF1 CISH may be a valuable adjunct for the diagnosis of TGCT of all types, especially those with atypical or malignant morphologic features. Detection of CSF1 mRNA expression may also have predictive significance in cases where use of the CSF1 inhibitor pexidartinib is considered.
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Affiliation(s)
| | - Justin W Koepplin
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Andrew L Folpe
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA.
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Arican M, Turhan Y. A Pregnant Woman with Multi-Fragmented Giant Cell Tumor of Tendon Sheath: A Rare Anatomical Location. J Am Podiatr Med Assoc 2020; 110:436242. [PMID: 31486673 DOI: 10.7547/19-038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Giant cell tumor of the tendon sheath (GCTTS) in the foot is a rare pathology and is involved in the differential diagnosis of soft-tissue tumors of the foot and ankle. Although it can affect any age group, GCTTS mainly occurs at the 3rd and 5th decade and is more common in females. Histopathologic examination is a major definitive method for diagnosis, although physical examination and radiologic imaging are helpful in reaching a diagnosis preoperatively. Many treatment options exist but marginal excision is the most commonly used treatment. We describe the case of a 26-year-old pregnant woman with a multi-fragmented mass extending from the first web space to the plantar aspect of the metatarsophalangeal joint (MTP) of the left great toe associated with flexor hallucis longus tendon after trauma. She had pain that worsened with activity and wearing shoes. After pregnancy, a marginal excision with dorsal longitudinal incision in the first web space was performed under spinal anesthesia. The lesion was diagnosed as a localized type tenosynovial giant cell tumor. At the last follow-up appointment in the 23rd month, the patient was doing well and there was no recurrence of the lesion. GCSST should be considered in the differential diagnosis of plantar masses of foot. Although, GCTTS is frequently seen in females, it has not been previously reported in a pregnant woman with an extremely rare condition after trauma.
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Zhao Q, Lu H. Giant cell tumor of tendon sheath in the wrist that damaged the extensor indicis proprius tendon: a case report and literature review. BMC Cancer 2019; 19:1057. [PMID: 31694605 PMCID: PMC6836650 DOI: 10.1186/s12885-019-6293-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 10/25/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Giant cell tumor of the tendon sheath (GCTTS) is a benign soft tissue (synovial membrane) tumor that rarely involves the hands or wrists. And Tendon impairment caused by GCTTS is extremely rare. CASE PRESENTATION Here, we reported a case of a 60-year-old female with a 10-year history of gradually increasing mass in her left dorsal wrist. The EIP tendon was partially impaired by the mass.The patient was treated with surgical excision of the mass and reconstruction of the EIP tendon. The histopathological examination suggested the presence of GCTTS. After surgery, the patient had adequate functional recovery and no tumor recurrence after 2 years' follow-up. CONCLUSION GCTTS in hands and wrists rarely damages the tendon. Early diagnosis and proactive interventions may likely contribute to good prognostic outcomes.
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Affiliation(s)
- Qingfang Zhao
- Department of Plastic Surgery, The First Affiliated Hospital, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province 310003 People’s Republic of China
| | - Hui Lu
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province 310003 People’s Republic of China
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Koutserimpas C, Kastanis G, Ioannidis A, Filippou D, Balalis K. Giant cell tumors of the tendon sheath of the hand: an 11-year retrospective study. J BUON 2018; 23:1546-1551. [PMID: 30570884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose: Giant cell tumor of the tendon sheath (GCTTS) is a slowly progressing soft tissue tumor. The present retrospective study recorded and evaluated cases of GCTTS of the hand. Methods: A cohort of patients suffering from GCTTS of the hand and treated surgically were studied in terms of diagnosis, therapy, recurrence, as well as in terms of functional outcome with the use of the QuickDASH score. Results: A total of 36 patients (13 men; 23 women) with a mean age of 38.8 years (±standard deviation;SD=8.7) were evaluated. According to Al-Qattan classification 10 cases of type Ia, 11 cases of type Ib, 6 cases of Ic and 9 cases of IIa were found, while the mean tumor diameter was 2.6 cm (SD=1.1). The mean follow up was 21 months (SD=12). The mean QuickDASH Score was 6.3 (SD=6.7). Furthermore, a total of 31 patients (86%) characterized their outcome as satisfactory. Recurrence was observed in 4 patients, while none of them had initially undergone radiotherapy. Conclusions: This study has shown a direct correlation between the QuickDASH Score results and the objective level of satisfaction in cases of GCTTS treated surgically. The present study cohort had 11.11% recurrence rate during a mean follow-up of 21 months. It is of note that none of these cases had initially undergone radiotherapy. It is of utmost importance to carefully select the patients that meet the criteria for postoperative radiotherapy.
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Affiliation(s)
- Christos Koutserimpas
- Department of Orthopedics and Traumatology, "251" Hellenic Air Force, General Hospital of Athens, Athens, Greece
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Zhao Z, Paquette C, Shah AA, Atkins KA, Frierson HF. Fine Needle Aspiration Cytology of Diffuse-Type Tenosynovial Giant Cell Tumors. Acta Cytol 2017; 61:160-164. [PMID: 28324880 DOI: 10.1159/000457828] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 01/23/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Tenosynovial giant cell tumor (TSGCT), also known as giant cell tumor of tendon sheath or pigmented villonodular synovitis, is the most common benign tumor of the tendon and synovium. The intra-articular diffuse type can present as a large infiltrative mass involving adjacent soft tissue and sometimes causes secondary destruction of bone, which leads to radiographic and clinical concern for malignancy. The tumor may also be purely extra-articular. CASE Here, we report the fine needle aspiration cytology findings of 2 cases of diffuse-type TSGCT with large mononuclear cells with eccentric nuclei, finely granular cytoplasm, and a peripheral well-defined cytoplasmic rim of hemosiderin ("ladybird cells"). CONCLUSION Although the presence of ladybird cells has been described in tissue sections of TSGCT, their identification in cytological specimens has not been reported to our knowledge. When observed, their presence may aid in differentiating TSGCT from other lesions with multinucleated osteoclast-type giant cells occurring at or near joints.
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Affiliation(s)
- Zimin Zhao
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Meng JH, Guo YX, Luo HY, Guo CB, Ma XC. [Diagnosis and treatment of diffuse tenosynovial giant cell tumor arising from temporomandibular joints]. Beijing Da Xue Xue Bao Yi Xue Ban 2016; 48:1049-1054. [PMID: 27987512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To retrospectively analyze the clinical features, treatment and prognosis to the diffuse tenosynovial giant cell tumor (D-TSGCT) arising from the temporomandibular joint (TMJ), and to give a reference for the early diagnosis and treatment of this disease. METHODS In this study, 15 patients finally diagnosed as D-TSGCT of TMJ histopathologically at the Peking University Hospital of Stomatology from October 2003 to August 2015 were selected and reviewed. Their clinical manifestations, imaging and histological features, diagnoses and differential diagnoses, treatments and follow-ups were summarized and discussed. RESULTS D-TSGCT of TMJ showed obvious female predominance (12/15), the main symptoms included painful preauricular swelling or mass, limited mouth-opening and mandibular deviation with movement. D-TSGCT on computed tomography (CT) scan often showed ill-defined soft tissue masses around TMJ, enhancement after contrast administration, usually with widening of the joint spaces and with bone destruction of the condyle, the fossa and even the skull base. On magnetic resonance images (MRI), the majority of lesions on T1 weighted images and T2 weighted images both showed the characteristics of low signals (6/11). The lesions could extend beyond the joints (9/11) and into the infratemporal fossa (4/11) and the middle cranial fossa (4/11). Surgical resection was performed in 14 cases and biopsy in 1 case. Postoperative radiotherapy was performed in 3 cases. In follow-ups, 3 cases showed recurrence postoperatively. CONCLUSION D-TSGCT arising from TMJ should be differentiated with TMJ disorders, other tumors and tumor-like lesions of TMJ and parotid neoplasms, etc. CT and MRI examinations have important values in the diagnosis and treatment design of D-TSGCT. Because of the local aggressive and extensive behavior, complete resection should be performed as soon as possible. Postoperative radiotherapy was helpful for the extensive lesions including destruction of skull base and may be a good supplementary therapy. Because of the possibility of recurrence and malignancy, long-term follow-up was suggested.
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Affiliation(s)
- J H Meng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Y X Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - H Y Luo
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - C B Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - X C Ma
- Center for Temporomandibular Joint Disorder and Orofacial Pain, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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