Giant cell tumors of the tendon sheath. About a new case

Giant cell tumors [GCT] are benign tumors of the tendon sheath, locally aggressive. Their prevalence comes only to 1.8 patients by one million inhabitants. They account for 18% of the benign tumors of hand and wrist. The location is in general unique. The affection can take two clinical forms. Thus, the GCT can be localized and appears under the aspect of an adherent nodule to a tendon, not painful and with slow growth. Elsewhere, it is diffuse and represents the equivalent in the sheaths or the serous purses of the pigmented villonodular synovitis. It affects young adults in general between the third and the fourth decade. Women seem more frequently affected than men. The location of predilection is fingers [80%]. Feet localization remains rare; we report one feet location. The aetiopathogenesis remains uncertain. Clinical expression of this entity is insidious. Standard radiographies are in general normal. MRI is the most performant exam for the analysis of the structure of synovial membrane nowadays. Biopsy confirms the diagnosis. The treatment is surgical and resection of the tumor must be complete with usually a favorable outcome. However local recurrence is frequent

arthrites juveniles idiopathiques traitees par methotrexate. Reponse au traitement et tolerance a myoen terme

The MTX has a place of choice in the treatment of the AJI with good observance and the absence of grave side effects. In a retrospective study, 14 cases of AJI having benefited from a treatment by MTX were included in the study. Answer to the treatment was estimated at the 6th month on the criteria of RINTO. The group included in the therapeutic evaluation, is formed by 10 boys and by 4 girls. The average age of the beginning of the disease is of 6 years [2 - 11]. The shape of the beginning is systematic in 7 cases and polyarticular in 5 cases and oligoarticular in 2 cases. The average duration of the treatment by MTX is of 36 months [9 - 66]. Answer to the MTX in the 6th month was noted in 7 cases, under a MTX's average dose of 7,14mg / m2 / week. Unwanted effects were observed in 7 cases and have not in any case led to the stop of the treatment