Distal Dorsal Thumb Mass: Giant Cell Tumor of the Tendon Sheath in an Unusual Location.

Giant cell tumor of the tendon sheath (GCTTS) is a common mass in the digits, hands, and upper extremities. Diagnosis is made on clinical examination, adjunctive imaging, and distinct intraoperative findings. Surgical excision is the mainstay of treatment. GCTTS are typically found on flexor surfaces with the dorsal distal thumb being an unusual location. Any surgical approach to the digit should balance oncologic margins with preserving function. GCTTS have a tendency to recur and should be approached in a methodical manner with risk factors of recurrence in mind. This case report reviews the history of GCTTS, surgical approaches to the digit, and risk factors for recurrence to achieve success in the surgical management of these tumors.

Arthroscopic Excision of Localized Nodular Tenosynovitis of Carpometacarpal Joint of Thumb: A Case Report and Review of Literature.

Giant cell tumors of tendon sheath are classified according to their clinical presentation as localized or diffuse, and they may occur at intra-articular or extra-articular locations. Although magnetic resonance imaging is mandatory and sufficient for diagnosis in many cases, histological examination is needed to confirm the diagnosis. Complete surgical resection is the mainstay of treatment. Radiotherapy as adjuvant or after recurrence shows promising results. Though small joint arthroscopy, especially of the thumb carpometacarpal (CMC) joint, is a relatively new technique and mainly used for the treatment of basal joint arthritis of the thumb, the indications are evolving. We report a rare case of nodular tenosynovitis of the CMC joint of the thumb managed with complete arthroscopic resection of the tumor, and no recurrence at a follow-up of 2.5 years. This is another addition to the list of indications for thumb CMC arthroscopy. Arthroscopic treatment provides the distinct advantage of thorough assessment of the articular cartilage, complete excision of the tumor via a minimally invasive technique, early return of function, and better cosmesis. To the best of our knowledge, this is the first such report of arthroscopic resection of nodular tenosynovitis of the thumb CMC joint.

Localized Nodular Tenosynovitis Originated near the Medial Plicae.

The authors report a case of localized nodular tenosynovitis originating from the medial plicae of the knee that was grossly observable, palpable, and symptomatic. A 41-year-old male visited our hospital with a complaint of knee pain that began 4 years ago. He complained of intermittent catching and a mass that appeared in the medial side of the knee 18 months ago. On magnetic resonance imaging, the mass was found on the plicae area of the medial side of the knee, and thus excisional biopsy was performed under arthroscopy. Histological study showed characteristics of localized nodular tenosynovitis originating from the synovium of the knee. At the 1-year postoperative outpatient follow-up, no symptoms or signs of recurrence were found. Since the authors experienced excellent postoperative results of arthroscopically assisted resection of a grossly observable and palpable localized nodular tenosynovitis originating from the synovium of the knee plicae, we report the case with a review of the literature.

Chondroid tenosynovial giant cell tumor of the toe: A case report / 동물의과학연구지

Localized tenosynovial giant cell tumor (TGCT) usually occurs in the hand and foot regions. However, localized TGCT with extensive cartilaginous metaplasia is rare, especially in the tendon sheath of the toe. Here, we report a case of localized TGCT with cartilaginous metaplasia in a 57-year-old man. The tumor presented as a lobular mass measuring 2.2 cm in its greatest dimension and arose in the flexor digitorum tendon sheath of the right 2nd toe. Clinically, the mass was palpable 1 year ago and brought pain during walking. Microscopically, the mass was composed of focal conventional TGCT and cartilaginous components. The conventional TGCT areas consisted of mononuclear cells, multinucleated giant cells, and hemosiderin deposition. The chondroid areas were extensive and comprised more than 90% of the whole tumor. In this case, the mononuclear cells in the conventional TGCT areas showed focal immunohistochemical staining for podoplanin and S100 protein as well as diffuse staining for CD68, which is consistent with the staining pattern of conventional TGCT. The mononuclear cells in the chondroid areas were focal positive for podoplanin and diffuse positive for S100 protein. Chondroid metaplasia in diffuse TGCT has been reported in 10 cases involving the temporomandibular, elbow, and hip joints. However, there has been no report of a localized form of chondroid TGCT involving an extra-articular region.

Localized Nodular Tenosynovitis Originated near the Medial Plicae

The authors report a case of localized nodular tenosynovitis originating from the medial plicae of the knee that was grossly observable, palpable, and symptomatic. A 41-year-old male visited our hospital with a complaint of knee pain that began 4 years ago. He complained of intermittent catching and a mass that appeared in the medial side of the knee 18 months ago. On magnetic resonance imaging, the mass was found on the plicae area of the medial side of the knee, and thus excisional biopsy was performed under arthroscopy. Histological study showed characteristics of localized nodular tenosynovitis originating from the synovium of the knee. At the 1-year postoperative outpatient follow-up, no symptoms or signs of recurrence were found. Since the authors experienced excellent postoperative results of arthroscopically assisted resection of a grossly observable and palpable localized nodular tenosynovitis originating from the synovium of the knee plicae, we report the case with a review of the literature.