Giant Cell Tumors of Tendon Sheath: Operative Findings and Relation to Recurrence

Journal of the Korean Society for Surgery of the Hand 2005;10(1):20-25.
Published online March 1, 2005.

Jong Pil Kim, M.D., Min Jong Park, Sung Han Ha,

건막 거대 세포종: 수술 소견과 재발의 관련성

김종필, 박민종, 하성한

Abstract

Purpose
To assess relation factors between operative findings of giant cell tumor of tendon sheath (GCTTS) and its recurrence. Materials and Methods: Forty-five cases which had been histologically diagnosed as GCTTS after surgery were reviewed. Twenty-nine were female and 16 were male, with the mean age of 37.6 years (range, 15~73 years). Clinical data, radiographs, and operative findings such as tumor size, adherence to surrounding tissues, and multicentricity were assessed. Tumors were classified into simple tendon sheath involvement, tendon infiltration, joint involvement, and bony involvement. The lesions with bony involvement were divided into bony indentation, periosteal infiltration, and intraosseous growth with cortical perforation. Twenty-eight patients were available for long-term follow-up averaging 3.8 years (range, 12 months to 9 years). The correlations between operative findings and recurrence rate were analyzed. Results: The tumor size ranged from 5 to 60 mm (mean, 23 mm) in its greatest diameter. Multicentricity was noted in 15 patients (33%), and severe adherence to the adjacent tissues in 13 patients (29%). Twenty-six simple tendon sheath involvement, 2 tendon infiltrations, and 17 joint or bony structure involvements were noted. Recurrence was observed or suspected in 11 of 28 patients who were available for long-term follow-up. Five of them underwent repeated excision. The statistical correlation was found between lesions which showed multicentricity or adherence to the adjacent tissues and high recurrence rate. Conclusion: GCTTS demonstrated variable patterns of involvements including tendon, joint, or bony structure between patients. The chance of recurrence might be greater when it is associated with multicentricity or adherence to the adjacent tissues. Close examination of the lesions and careful surgical excision are required in patients with GCTTS to minimize the risk of recurrence.