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Nodular giant cell tumour of the tendon sheath of the hand: analysis of eighty-four cases—diagnostic decisions and outcome

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Abstract

Introduction

The giant cell tumour of the tendon sheath (GCTTS) of the hand is a benign tumour of unknown origin. The clinical diagnosis is supported by preoperative imaging. But the ideal imaging methods necessary for the diagnosis, preoperative planning and total tumour resection are still debated. Standard treatment is surgical resection with histological confirmation.

Methods

We followed up 84 patients who were operated upon for a histologically confirmed nodular type GCTTS for an average of 4.7 years (range four to eight). The preoperative symptoms and radiological findings of X-ray, ultrasound and MRI were reviewed and the surgeon asked for their impact on the surgical procedure.

Results

The average age at operation was 50.9 years, 65.5 % of the patients were female and 61.9 % of the lesions were located on the palmar aspect. Most tumours were found on the first three fingers. Two patients had tumours at two separate sites (2.4 %). After an average follow up of 31.5 months two recurrences were observed (2.4 %). In addition to X-ray and ultrasound, the preoperative findings of the MRI had no influence on the surgical procedure.

Conclusion

Our data on the nodular GCTTS are in accordance with published data concerning the age distribution, gender distribution, and localisation. No soft-tissue imaging method is superior for the diagnosis of nodular GCTTS or for the preoperative planning. A preoperative MRI may not be necessary as clinical and ultrasound examination are sufficient. To exclude bony erosions, a preoperative X-ray is necessary.

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Authors and Affiliations

  1. Department for the Upper Extremity, Hand-, and Microsurgery, Immanuel Hospital, Königstr. 63, 14109, Berlin, Germany

    Martin Lautenbach & Simon Kim

  2. Department for Hand-, Replantation- and Microsurgery, Unfallkrankenhaus Berlin, Warener Straße 7, 12683, Berlin, Germany

    Michael Millrose & Andreas Eisenschenk

  3. Centre for Hand Surgery, University Hospital Greifswald, F.-Sauerbruch-Straße, 17475, Greifswald, Germany

    Simon Kim & Andreas Eisenschenk

Authors
  1. Martin Lautenbach
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  2. Simon Kim
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  3. Michael Millrose
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  4. Andreas Eisenschenk
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Correspondence to Simon Kim.

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Lautenbach, M., Kim, S., Millrose, M. et al. Nodular giant cell tumour of the tendon sheath of the hand: analysis of eighty-four cases—diagnostic decisions and outcome. International Orthopaedics (SICOT) 37, 2211–2215 (2013). https://doi.org/10.1007/s00264-013-1994-2

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  • DOI: https://doi.org/10.1007/s00264-013-1994-2

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