Tenosynovial giant cell tumors are extremely rare tumors with highly nonspecific symptoms. This benign but aggressive disease has a slow course of progression; however, it can ultimately lead to irreversible damage to a joint. Here we describe a case of a 45-year-old female with a diagnosis of tenosynovial giant cell tumors of the distal tibiofibular joint, the second case described in the literature for such location. Appropriate imaging studies and ultimately histologic studies are necessary for the correct diagnosis. Some locations are particularly unusual for these tumors making a high level of suspicion as well as treatment by an oncology orthopedic surgery specialist at a high-volume center paramount.

The proximal humerus is a common location for bone tumors. Those can affect patients of different ages and can be of benign or malignant nature. For bone sarcomas is the 3rd most common location and is a frequent site of spread in non-axial metastatic disease. In pediatric patients is frequent to encounter benign bone tumors in this location but also osteosarcomas and Ewing’s sarcomas. Careful assessment of the patients by a surgeon with the appropriate training is paramount. Shoulder reconstruction for patients with bone tumors encompasses a diverse group of patients, diagnoses and surgical options. While most patients with primary bone tumors may be of a younger age and more involved in sport activities, those with metastatic disease oftentimes are associated with an older age, worse preoperative function and worse prognosis due to the primary disease. The surgeon must weigh in all factors that need to be taken into consideration in the treatment decision-making plan. Currently, with new advances in oncology treatments patients may benefit from longer survivals times than in the past, thus restoring the patient’s function and quality of life is essential.

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