[Tenosynovial giant cell tumors of soft tissues of the hand about 15 cases]

ABSTRACT

Giant cell tumors of the tendon sheath [GCTTS] or tenosynovial giant cell tumors are a group of rare proliferative disorders which involves synovial johns and tendon sheaths. The authors report a series of 15 cases of giant cell tumors of the tendon sheath of the soft tissues of the hand collected between 2000 and 2005. In this series, the middle age at the time Of the diagnosis was 3S years. The sex ratio was 1.5. The tumor was located on the thumb on 5 patients, in the ring-finger in 4 cases and in the middle finger on 3 patients. There were 2 cases of giant cell tumors of the tendon sheath on the little finger and one case of giant cell tumor of the tendon sheath located on the forefinger. The clinical features were a polylobulated tumor, well limited, painless of firm consistence, adhesive on a deep level, the joints of the lingers were free, except for 2 patients who presented a limitation of the mobility of the proximal inter phalanxial joint. The standard radiological imagery of the hand centred on the finger presenting the tumor were normal, except on one case in which the tumor had invaded the bone letting a print on the third phalanx. A surgical biopsy was performed for all patients, the operative explorations found a polylobulated tumor, well limited, yellow-chamois with darker greyish strips. The histological study confirmed that it is a tenosynovial giant cell tumor and that there were not histological signs of malignancy. The results were valued with a middle receding of 3 years, there were not cases of post-operative infections nor algodystrophia. Concerning the functional level, one patient kept a limitation of the mobility on the proximal inter phalanxial joint. Only one case of tumoral recurrence was noted because the tumor had invaded the bone and the distal inter phalanxial joint