Extra-articular diffuse-type tenosynovial giant cell tumor with benign histological features resulting in fatal pulmonary metastases

Osanai, Toshihisa; Suzuki, Hiroaki; Hiraga, Hiroaki; Soma, Tamotsu; Nojima, Takayuki

doi:10.1177/2309499017690323

Cited by 5 publications

(1 citation statement)

References 13 publications

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“…In addition, reports of complete extra-articular diffuse-type TSGCT located within the soft tissues of the thigh or subcutaneously have been seen ( 7 , 8 ). Osanai et al ( 9 ) reported one case of diffuse-type TSGCT located within the right gluteus maximus muscle with a lesion located completely outside the joint and not associated with the joint capsule and synovium. This is similar to the region reported in this study, in which one case was located in the medial region of the left lesser trochanter and the deep surface of the gluteus, which was completely extra-articular and did not invade the hip joint, while the other case was located around the greater sciatic foramen in the deep surface of the left gluteus, with a dumbbell-shaped lesion expanding from posterior to anterior and invading the left sacroiliac joint, but no significant association with the joint capsule or bursa was seen.…”

Section: Discussionmentioning

confidence: 99%

Dumbbell-type tenosynovial giant cell tumor of the buttocks: a report of two cases

Liu¹,

Lei²,

Yuan³

et al. 2022

Transl Cancer Res TCR

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Background: Tenosynovial giant cell tumor (TSGCT) is a benign tumor derived from the synovium of the joints, bursa, and tendon sheaths, which is mainly located around the tendon sheath of hand and foot. Extraarticular TSGCT are relatively rare and are mainly found in the soft tissue around the large joint. They are rarer when located purely intramuscular or subcutaneous, and mostly in the lower extremities.Case Description: We report two rare cases of completely extra-articular TSGCT located at the buttocks. One case was a 23-year-old young male presenting with left buttock swelling and pain for 1 year. Magnetic resonance imaging (MRI) examination revealed a dumbbell-type cystic solid mass in the left buttock, growing anteriorly from the deep surface of the gluteus muscle along the medial of the lesser trochanter. The lesion showed a heterogeneous mixed signal and was well-defined. MRI presentation needs to be differentiated with neurogenic or mesenchymal tumors, and radical resection of left gluteal tumor + neurovascular exploration surgery was performed. Another case of TSGCT we present here was diagnosed in a 55-year-old male elderly patient. Computed tomography angiography (CTA) revealed an irregular soft tissue mass in the left buttock involving the sacroiliac joint. T1-weighted imaging (T1WI) on MRI showed a mixed signal with predominantly isosignal, well-defined, and seemingly enveloped. A left buttock tumor resection with the scraping of the sacroiliac joint lesion was performed.Conclusions: Based on histopathological examination, the diagnosis was diffuse-type TSGCT for both cases. Both patients were periodically monitored after surgery, and one of them showed no imaging findings of recurrence or metastases seven years after surgery; the other case showed recurrence one year after surgery, which was resected and treated with radiotherapy, and there has been no recurrence so far. TSGCT occurring completely intramuscular is rare, with atypical clinical symptoms and imaging presentation, requiring differentiation with mesenchymal and giant cell-rich tumors.

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Section: Discussionmentioning

confidence: 99%

Dumbbell-type tenosynovial giant cell tumor of the buttocks: a report of two cases

Liu¹,

Lei²,

Yuan³

et al. 2022

Transl Cancer Res TCR

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Malignant Diffuse Tenosynovial Giant Cell Tumor: Case Report and Review of the Literature

MacMahon¹,

Chaudhry²,

James³

et al. 2021

AJSP: Reviews and Reports

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Diffuse-type tenosynovial giant cell tumor (TGCT) is a neoplasm that exhibits infiltrative growth, tends to recur locally, and is often located within a joint. We describe a challenging diagnosis and clinical course of a 14-year-old girl with malignant diffuse TGCT, highlighting the difficulty of acquiring a representative biopsy. The patient presented with a painful foot mass, which was diagnosed initially through open biopsy as chronic osteomyelitis. Because her pain persisted, additional open biopsies were performed 1 and 2.5 years after the initial biopsy, which also showed features of benign TGCT. At age 16 years, she underwent marginal resection but developed local recurrence with metastatic disease 1 year later. Core needle biopsy of the foot mass again confirmed diffuse TGCT and showed no evidence of atypical or malignant features. Malignant features were confirmed only through excisional biopsy of chest wall metastasis. The patient started chemotherapy and underwent below-the-knee amputation at age 17 years. Amputation specimen showed malignant diffuse TGCT. She died of disease progression approximately 1 year later. Metastasis of diffuse TGCT with benign histology is challenging to diagnose. Previous studies have also found that benign diffuse TGCT can transform into an aggressive, malignant tumor. This case highlights that biopsy sampling can be challenging in histologically heterogeneous tumors. Initial evaluation by a multidisciplinary team, as well as image-guided biopsy techniques, may increase diagnostic accuracy of the biopsy.

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Localized type tenosynovial giant cell tumor with metastases to lungs and pleura: a case report and literature review

Shaik,

Panigrahi,

Patro

et al. 2024

J Med Case Reports

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Background Tenosynovial giant cell tumor is a rare soft tissue tumor of the synovium of joint, bursae, or tendon sheath. It is divided into localized or diffuse types on the basis of the growth pattern. Localized tenosynovial giant cell tumors are usually benign and treated successfully by excision. Diffuse tenosynovial giant cell tumors, in contrast to localized type, can destroy bone and cartilage and are associated with frequent local recurrences and distant metastasis. Localized type tenosynovial giant cell tumors rarely metastasize to distant organs. Here, we report a case of localized tenosynovial giant cell tumor presenting with lung metastases and systematically review literature. Case presentation A 55-year-old Asian male presented with a dry cough, right-sided chest pain and progressive dyspnea for 1 month. At 18 months before this presentation, he had undergone excision of a painless swelling on his right index finger. The swelling recurred within 3 months of excision, and a biopsy was then suggestive of a giant cell tumor. Given the suspicion of a giant cell tumor, a wide excision of the lesion was performed and the excisional biopsy was consistent with a diagnosis of tenosynovial giant cell tumor, localized type. At admission to our hospital, the patient had tachypnoea and absent breath sounds on the right side. A chest radiograph showed a right-sided pleural effusion with a homogenous opacity in the left mid-zone. A contrast-enhanced computed tomography of the chest and abdomen showed right massive pleural effusion and bilateral multiple lobulated heterogeneously enhancing pleural-based masses with areas of internal calcification. Pleural fluid analysis revealed an exudate with no malignant cells on cytology. A lung biopsy showed osteoclast-like giant cells and mononuclear spindle cells with areas of hemorrhage and necrosis, suggesting tenosynovial giant cell tumor metastasis. A final diagnosis of localized type tenosynovial giant cell tumor of the right index finger with metastases to the lungs and pleura was made. The patient passed away after receiving three cycles of denosumab injection owing to progressive disease. Conclusion Lung metastasis is extremely rare in patients with localized tenosynovial giant cell tumor. The survival is usually poor in patients with lung metastasis. A close follow-up of patients with localized type tenosynovial giant cell tumor is necessary for early detection of pleuropulmonary complications.

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Extra-articular diffuse-type tenosynovial giant cell tumor with benign histological features resulting in fatal pulmonary metastases

Cited by 5 publications

References 13 publications

Dumbbell-type tenosynovial giant cell tumor of the buttocks: a report of two cases

Dumbbell-type tenosynovial giant cell tumor of the buttocks: a report of two cases

Malignant Diffuse Tenosynovial Giant Cell Tumor: Case Report and Review of the Literature

Localized type tenosynovial giant cell tumor with metastases to lungs and pleura: a case report and literature review

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