Retrospective Study of the Results of Surgical Treatment of 31 Giant Cell Tumors of the Tendon Sheath in the Hand^[*]

Abstract

Objective

To evaluate the results of the treatment of 31 giant-cell tumors of the tendon sheath of the hand cared for between 2006 and 2015.

Methods

A group of patients for the present retrospective evaluation was defined, covering the period between February 2006 and November 2015, in which 31 records of patients who underwent surgery due to cell tumor of the tendon sheath of the fingers were studied and evaluated. The recommended treatment was complete excision of the tumor with preservation of the adjacent structures. The diagnosis was confirmed by pathological examination. The progress of the treatment after surgery was evaluated, especially regarding the rate of tumor recurrence.

Results

Taking all 31 patients into consideration, there was a predominance of the female gender and white ethnicity. Most of these patients were aged between 30 and 50 years. The most affected side was the left one, and most tumors were in the flexor face. There was a predominance of the radial fingers, along with their distal end. A total of 27 patients are being followed up at regular intervals at an outpatient clinic, and three cases of tumor recurrence have been identified.

Conclusion

An appropriate surgical technique is essential in order to prevent GCTTS recurrences. The results obtained in this research are in agreement with the literature.

Keywords

neoplasms - hands - giant-cell tumors

^* Work developed at the Department of Orthopedics and Traumatology, Irmandade da Santa Casa de Misericórdia de Marília, Marília, SP, Brazil.

• Referências

• 1 Chassaignac M. Cancer de la gaine des tendons. Gaz Hosp Civ Milit 1852; 47: 185-6
• 2 Weiss SW, Goldblum JR, Folpe AL. Enzinger and Weiss's soft tissue tumors. 6 th ed. Philadelphia: Saunders; 2014
• 3 Adams EL, Yoder EM, Kasdan ML. Giant cell tumor of the tendon sheath: experience with 65 cases. Eplasty 2012; 12: e50
• 4 Lancigu R, Rabarin F, Jeudy J, Saint Cast Y, Cesari B, Fouque PA. , et al. Giant cell tumors of the tendon sheaths in the hand: review of 96 patients with an average follow-up of 12 years. Orthop Traumatol Surg Res 2013; 99 (4, Suppl) S251-4
• 5 Reilly KE, Stern PJ, Dale JA. Recurrent giant cell tumors of the tendon sheath. J Hand Surg Am 1999; 24 (06) 1298-302
• 6 Williams J, Hodari A, Janevski P, Siddiqui A. Recurrence of giant cell tumors in the hand: a prospective study. J Hand Surg Am 2010; 35 (03) 451-6
• 7 Valentini JD, Aguiar DF, Ferdinando MPL, Wagner M, Silva JB. Tumores da mão parte I: tumores de partes moles da mão. Rev AMRIGS 2015; 59 (03) 237-42
• 8 Lautenbach M, Kim S, Millrose M, Eisenschenk A. Nodular giant cell tumour of the tendon sheath of the hand: analysis of eighty-four cases: diagnostic decisions and outcome. Int Orthop 2013; 37 (11) 2211-5
• 9 Moser E. Primares sarkom der fussgelenklapsel Extirpation. Dauerheiung. Dtsch Z Chir 1909; 98: 306-10
• 10 Jaffe H, Lichtenstein L, Sutro CJ. Pigmented villonodular synovitis, bursitis and tenosynovitis. Arch Pathol (Chic) 1941; 31: 731-65
• 11 Botez P, Sirbu PD, Grierosu C, Mihailescu D, Savin L, Scarlat MM. Adult multifocal pigmented villonodular synovitis--clinical review. Int Orthop 2013; 37 (04) 729-33
• 12 Glowacki KA. Giant cell tumors of tendon sheath. J Hand Surg Am 2003; 3 (02) 100-7
• 13 Di Grazia S, Succi G, Fragetta F, Perrotta RE. Giant cell tumor of tendon sheath: study of 64 cases and review of literature. G Chir 2013; 34 (5-6): 149-52
• 14 Hwang JS, Fitzhugh VA, Gibson PD, Didesch J, Ahmed I. Multiple giant cell tumors of tendon sheath found within a single digit of a 9-year-old. Case Rep Orthop 2016; 2016: 1834740
• 15 Silva JB, Calcagnotto GN, Scolari J, Fridman M. Tumor de células gigantes da bainha tendinosa ao nível dos dedos: exérese através da incisão circunferencial. Rev Bras Ortop 2002; 37 (04) 129-32
• 16 Pedrinelli A, Camargo OP, Barreto RB, Moldenhauer D, Pedrinelli R. Tumor de células gigantes de bainha de tendão no LCA. Acta Ortop Bras 2007; 15 (03) 171-3
• 17 Fotiadis E, Papadopoulos A, Svarnas T, Akritopoulos P, Sachinis NP, Chalidis BE. Giant cell tumour of tendon sheath of the digits. A systematic review. Hand (N Y) 2011; 6 (03) 244-9
• 18 Alves MPT. Excision of giant cell tumor of tendon sheath with bone involvement by means of double access approach: case report. Rev Bras Ortop 2015; 46 (01) 101-6
• 19 Osman W, Alaya Z, Haggui A, Rejeb MB, Jemni S, Naouar N. , et al. Les tumeurs à cellules géantes des gaines synoviales de la main: à propos de 50 cas. Pan Afr Med J 2017; 26 (128) 8p
• 20 Green DP, Hotchkiss RN, Pederson WC. Green's operative hand surgery. 6 th ed. New York: Churchill Livingstone; 2010
• 21 Al-Qattan MM. Giant cell tumours of tendon sheath: classification and recurrence rate. J Hand Surg [Br] 2001; 26 (01) 72-5
• 22 Yamaguchi T, Dorfman HD. Giant cell reparative granuloma: a comparative clinicopathologic study of lesions in gnathic and extragnathic sites. Int J Surg Pathol 2001; 9 (03) 189-200
• 23 Loréa P, Medina J, Navarro R, Foucher G. Récidive des tumeurs à cellules géantes des gaines tendineuses digitales après exérèse par une voie d'abord dite des “dents de la mer”. A propos de 25 cas. Ann Chir Plast Esthet 2001; 46 (06) 607-10
• 24 Hosaka M, Hatori M, Smith RA, Kokubun S. A cell line with multinucleated giant cell formation established from a human giant cell tumor of tendon sheath--preliminary report. J Orthop Sci 2001; 6 (05) 414-8