Giant-cell tumor of the tendon sheath (GCTTS) is a benign soft tissue tumor of the limbs arising from the complex of the tendon sheath and periarticular soft tissues of small joints. It is the second most common benign space occupying lesion in the hand and usually presents as a painless soft tissue mass, which grows slowly in size for many years. We present an interesting case of an enormous GCTTS presenting as a slowly growing mass over left sole of a 52-year-old woman. The duration of GCTTS may range from a few weeks to 30 years but in our case the duration of tumor was almost 48 years, which could be the longest reported duration of GCTTS.

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Palisading granulomas are seen in granuloma annulare, necrobiosis lipoidica diabeticorum, rheumatoid nodule, sarcoidosis, and fungal and mycobacterial infections. Radiography, Mantoux test, culture and PCR, and staining of histological sections should be performed to differentiate these conditions. [8]