Giant Cell Tumor of Tendon Sheath of the Handa Retrospective Study

Giant cell tumor of tendon sheath (GCTTS) is the second most common benign tumor of the hand. Simple excision is the treatment of choice if any related discomfort occurs. Based on the most widely accepted hypothesis, GCTTS is a reactive or regenerative hyperplasia associated with an inflammatory process. However, it still can cause cortical erosion and recur at times. This study proposes to evaluate the clinical features and therapeutic opinions of the tumor and identify the probable recurrence risks. From January 2008 to December 2013, 23 patients with GCTTS of the hand had surgical interventions at our institute. Plain X-rays and magnetic resonance image (MRI) were performed before surgeries. The tumors were removed by marginal or intralesional excision according to their morphology. One patient had accompanied cortical erosion was treated with thorough bone curettage and graft with artificial bone substitutes in addition to tumor excision. Seven patients had transient finger paresthesia after operation and got remission within 3months. Three had permanent finger paresthesia but improved after medications. No vascular injury or limited motion was noted. During the average follow-up period of 28.5months (24 similar to 35), 3 patients with multi-lobulated tumors had recurrence requiring re-exploration. Surgical excision provides good outcomes of treating the symptomatic GCTTS. Tumor morphology could be a risk factor for recurrence. Higher recurrence rate is associated with not only the type II tumors but also the type I tumors with multi-lobulated pattern.