gms | German Medical Science

Objectives/Interrogation: Giant cell tumor of the tendon sheath (GCTTS) is the second most common tumor of the hand after ganglion cysts. However, the local recurrence after excision has been reported in 5-30% of cases. The purpose of this study is to evaluate the clinical results of patients and to determine the risk factor of recurrence.

Methods: From 2002 to 2017, 32 patients [17 males, 16 females, mean age 50, ranging from 13-77 years] underwent excision of GCTTS of the hand. The average follow-up time was 15 months (3-180), the disease duration was 19 months (1-60), and the size of tumor was 14.5 mm (11-25). We always used the operating microscope during resection of tumors. We evaluated size of tumor, disease duration, bone erosion, pseudocapsule, and tumor-occupying factor.

Results: Recurrence was noted in only one case, who was successfully managed by a second excision. 2 cases were recurred after resection in other hospitals. Recurrence group (n=3) and control (n=29) were compared, but we could not find the risk factor for recurrence with a statistically significant difference. 2 cases were recurred in the proximal interphalangeal (PIP) joint.

Discussion: The local recurrence of GCTTS was caused by incomplete resection or satellite lesion. GCTTS in or around PIP joint was difficult to remove adequately, because the neurovascular structures are quite close to tumor margins. To prevent recurrence, some literatures suggested postoperative radiotherapy or use of imatinib. However, they have been still controversial. We guess the pre-operative planning and microscopic resection are important to prevent recurrence.

Conclusion: GCTTS in the hand are a common benign soft tissue tumor. Incomplete resection and satellite lesion seem to be the main factors influencing the rate of recurrence.