Skip to main content
SpringerLink
Log in

Giant cell tumour of tendon sheath with bone invasion in extremities: analysis of clinical and imaging findings

  • MUSCULOSKELETAL RADIOLOGY
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to review the clinical and imaging characteristics of giant cell tumour of tendon sheath (GCTTS) with bone invasion.

Materials and methods

Radiography (n = 9), magnetic resonance imaging (MRI) (n = 7), computed tomography (CT) (n = 4) and clinical findings of nine patients with surgically and pathologically confirmed GCTTS with bone invasion were retrospectively reviewed. Specific imaging findings including tumour site, maximum tumour size, shape, margin, density or signal intensity, bone invasion, periosteal reaction, calcification, and cystic areas were documented.

Results

There were five males and four females, with median age of 34 years. Presenting symptoms were painless mass in five patients, painful mass in two, intermittent pain and swelling in one and pain without mass in one. Five tumours were in the ankle–foot region, two in the hand, one in the cubital fossa and one in the patellofemoral joint. The total symptom duration ranged from 5 months to 6 years (median 12 months). The maximum tumour size ranged from 1.0 to 6.8 cm (median 3.0 cm). Radiographically, all tumours appeared as cortical destruction with well-defined margins. Four patients underwent CT scanning that clearly showed an iso-attenuated mass with intraosseous soft tissue. MR scanning was performed in seven patients who demonstrated a round, oval, spindle-shaped or multilobular soft tissue mass near or inside the joint with cortical destruction and intraosseous soft tissue. Five lesions were homogeneous moderate signal on T1WI. Moderate (n = 1), slightly high or high (n = 2) and low (n = 2) signal intensities were evident on T2WI. Two lesions showed heterogeneous low-to-moderate signal intensities on T1WI and mixed low signal intensities on T2WI.

Conclusions

GCTTS is a benign soft tissue mass that may present as an intraosseous lesion near extremity joints and frequently occurring in foot and hand on radiological examinations. GCTTS with bone invasion should be considered when MRI shows solid mass with characteristic low signal on T2-weighted images.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Lantos JE, Hameed M, Healey JH, Hwang S (2013) Giant cell tumour of the tendon sheath mimicking a primary intramedullary metatarsal tumour. Skeletal Radiol 42:589–593

    Article  PubMed  Google Scholar 

  2. Ho CY, Maleki Z (2012) Giant cell tumour of tendon sheath: cytomorphologic and radiologic findings in 41 patients. Diagn Cytopathol 40(Suppl 2):E94–E98

    Article  PubMed  Google Scholar 

  3. Ferrer J, Namiq A, Carda C, Lopez-Gines C, Tawfik O, Llombart-Bosch A (2002) Diffuse type of giant-cell tumour of tendon sheath: an ultrastructural study of two cases with cytogenetic support. Ultrastruct Pathol 26:15–21

    Article  PubMed  Google Scholar 

  4. Vogrincic GS, O’Connell JX, Gilks CB (1997) Giant cell tumour of tendon sheath is a polyclonal cellular proliferation. Hum Pathol 28:815–819

    Article  CAS  PubMed  Google Scholar 

  5. Murphey MD, Rhee JH, Lewis RB, Fanburg-Smith JC, Flemming DJ, Walker EA (2008) Pigmented villonodular synovitis: radiologic-pathologic correlation. Radiographics 28:1493–1518

    Article  PubMed  Google Scholar 

  6. Patel MR, Zinberg EM (1984) Pigmented villonodular synovitis of the wrist invading bone—report of a case. J Hand Surg Am 9:854–858

    Article  CAS  PubMed  Google Scholar 

  7. Carpintero P, Serrano J, Garcia-Frasquet A (2000) Pigmented villonodular synovitis of the wrist invading bone—a report of 2 cases. Acta Orthop Scand 71:424–426

    Article  CAS  PubMed  Google Scholar 

  8. Paparo F, Fabbro E, Piccazzo R et al (2012) Multimodality imaging of intraosseous ganglia of the wrist and their differential diagnosis. Radiol Med 117:1355–1373

    Article  CAS  PubMed  Google Scholar 

  9. Uriburu IJ, Levy VD (1998) Intraosseous growth of giant cell tumours of the tendon sheath (localized nodular tenosynovitis) of the digits: report of 15 cases. J Hand Surg Am 23:732–736

    Article  CAS  PubMed  Google Scholar 

  10. Booth KC, Campbell GS, Chase DR (1995) Giant cell tumour of tendon sheath with intraosseous invasion: a case report. J Hand Surg Am 20:1000–1002

    Article  CAS  PubMed  Google Scholar 

  11. Lu CT, Chen HC, Coskunfirat OK (2004) Immediate toe transfer following index finger amputation for extensive giant cell tumour of the tendon sheath with intraosseous invasion. Chang Gung Med J 27:312–317

    PubMed  Google Scholar 

  12. Fogelson MH, Dao KD, Shin AY (2003) Intraosseous metacarpal involvement of giant cell tumour of the tendon sheath: report of two cases. Am J Orthop (Belle Mead NJ) 32:32–34

    Google Scholar 

  13. Choughri H, Moussaoui A, Nonnenmacher J (2005) Giant cell tumour of the tendon sheath with intraosseous phalangeal invasion: a case report and review of the literature. Eur J Orthop Surg Traumatol 15:151–156

    Article  Google Scholar 

  14. De Schepper AM, Hogendoorn PC, Bloem JL (2007) Giant cell tumours of the tendon sheath may present radiologically as intrinsic osseous lesions. Eur Radiol 17:499–502

    Article  PubMed  Google Scholar 

  15. Erler K, Demiralp B, Ozdemir MT, Kaya A, Basbozkurt M (2004) Giant cell tumour of tendon sheath simulating giant cell tumour of bone: report of a case. J Surg Orthop Adv 13:124–127

    PubMed  Google Scholar 

  16. Guryel E, Coleridge S, Bendall S (2004) Unusual presentation of a giant cell tumour of the tendon sheath in the foot. J Surg Orthop Adv 13:110–111

    PubMed  Google Scholar 

  17. Wan JM, Magarelli N, Peh WC, Guglielmi G, Shek TW (2010) Imaging of giant cell tumour of the tendon sheath. Radiol Med 115:141–151

    Article  CAS  PubMed  Google Scholar 

  18. Reilly KE, Stern PJ, Dale JA (1999) Recurrent giant cell tumours of the tendon sheath. J Hand Surg Am 24:1298–1302

    Article  CAS  PubMed  Google Scholar 

  19. Wang Y, Tang J, Luo Y (2007) The value of sonography in diagnosing giant cell tumours of the tendon sheath. J Ultrasound Med 26:1333–1340

    CAS  PubMed  Google Scholar 

  20. Rodrigues C, Desai S, Chinoy R (1998) Giant cell tumour of the tendon sheath: a retrospective study of 28 cases. J Surg Oncol 68:100–103

    Article  CAS  PubMed  Google Scholar 

  21. Rao AS, Vigorita VJ (1984) Pigmented villonodular synovitis (giant-cell tumour of the tendon sheath and synovial membrane). A review of eighty-one cases. J Bone Joint Surg Am 66:76–94

    CAS  PubMed  Google Scholar 

  22. Glowacki KA, Weiss AP (1995) Giant cell tumours of tendon sheath. Hand Clin 11:245–253

    CAS  PubMed  Google Scholar 

  23. Noordanus RP, Hage JJ, van der Valk P (1995) “Borderline” giant cell tumour of the tendon sheath in the hand: to amputate or not? Case report. Scand J Plast Reconstr Surg Hand Surg 29:73–76

    Article  CAS  PubMed  Google Scholar 

  24. Myers BW, Masi AT (1980) Pigmented villonodular synovitis and tenosynovitis: a clinical epidemiologic study of 166 cases and literature review. Medicine 59:223–238

    Article  CAS  PubMed  Google Scholar 

  25. Llauger J, Palmer J, Roson N, Cremades R, Bague S (1999) Pigmented villonodular synovitis and giant cell tumours of the tendon sheath: radiologic and pathologic features. AJR 172:1087–1091

    Article  CAS  PubMed  Google Scholar 

  26. Gibbons CL, Khwaja HA, Cole AS, Cooke PH, Athanasou NA (2002) Giant-cell tumour of the tendon sheath in the foot and ankle. J Bone Joint Surg Br 84:1000–1003

    Article  CAS  PubMed  Google Scholar 

  27. Karasick D, Karasick S (1992) Giant cell tumour of tendon sheath: spectrum of radiologic findings. Skeletal Radiol 21:219–224

    CAS  PubMed  Google Scholar 

  28. Jelinek JS, Kransdorf MJ, Shmookler BM, Aboulafia AA, Malawer MM (1994) Giant cell tumour of the tendon sheath: MR findings in nine cases. AJR 162:919–922

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare no conflict of interest.

Ethical standards

This article does not contain any studies with human participants or animals performed by any of the authors.

Author information

Authors and Affiliations

  1. Department of Radiology, Union Hospital, Fujian Medical University, No. 29, Xinquan Road, Fuzhou, 350001, China

    Cheng-Sheng Wang, Qing Duan, Yun-Jing Xue, Xin-Ming Huang, Li-Li Wang, Zhi-Yong Chen, Jian-Hua Chen & Bin Sun

Authors
  1. Cheng-Sheng Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Qing Duan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yun-Jing Xue
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xin-Ming Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Li-Li Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Zhi-Yong Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jian-Hua Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Bin Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Qing Duan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, CS., Duan, Q., Xue, YJ. et al. Giant cell tumour of tendon sheath with bone invasion in extremities: analysis of clinical and imaging findings. Radiol med 120, 745–752 (2015). https://doi.org/10.1007/s11547-015-0520-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11547-015-0520-6

Keywords

Search

Navigation