Giant cell tumor of tendon sheath: Open surgery or arthroscopic synovectomy? A systematic review of the literature

Noailles, Thibaut; Brulefert, Kévin; Briand, Sylvain; Longis, P.-M.; Andrieu, K; Chalopin, Antoine

doi:10.1016/j.otsr.2017.03.016

Cited by 43 publications

(40 citation statements)

References 63 publications

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“…Synovectomies were mostly performed open. To date, literature reported con icting results regarding different surgical techniques, not favoring one over another [15,32,33]. However, we hypothesize that open surgery may allow for better overview of tumor, located intra-and extra-articular, with extension to surrounding tissues, possibly resulting in more complete removal of disease burden.…”

Section: Discussionmentioning

confidence: 87%

“…TOPP represents the largest prospective, international, multi-center disease registry for dt-TGCT, being able to include 166 patients in slightly more than 2 years, and shows that conducting collaborative observational studies for rare tumor is feasible. Current literature is largely focused on the oncological outcomes of this often chronic disease [15,16,17,18,19,20,21,22]. Data derived from this registry made it possible for the rst time to describe the dt-TGCT patient journey and treatment decisions around disease onset and diagnosis of dt-TGCT patients.…”

Section: Discussionmentioning

confidence: 99%

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The diffuse-type tenosynovial giant cell tumor (dt-TGCT) patient journey: a prospective real-world study

Bernthal¹,

Spierenburg²,

Healey³

et al. 2020

Preprint

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Background: Tenosynovial giant cell tumor (TGCT) is a rare locally aggressive neoplasm arising from the synovium of joints, bursae, and tendon sheaths affecting small and large joints. It represents a wide spectrum ranging from minimally symptomatic to massively debilitating. The majority of findings to date are mainly from small, retrospective case series, and thus the morbidity and actual impact of this rare disease remain to be elucidated. This study explores prospectively the real-world management of TGCT.Methods: The TGCT Observational Platform Project (TOPP) registry was a multinational, multicenter, prospective observational study involving 12 tertiary sarcoma centers in 7 European countries, and 2 US sites. This study enrolled for 2 years all consecutive ≥ 18 years old patients, with histologically diagnosed primary or recurrent cases of diffuse-type TGCT. Patient demographic and clinical characteristics were collected at baseline and every 6 months for 24 months. Quality of life questionnaires (PROMIS-PF and EQ-5D) were also administered at the same time-points. Here we report baseline patient characteristics.Results: 166 patients were enrolled between November 2016 and March 2019. Baseline characteristics were: mean age 44 years (mean age at disease onset: 39 years), 139/166 (83.7%) had prior treatment, 71/166 patients (42.8%) had ≥ 1 recurrence after treatment of their primary tumor, 76/136 (55.9%) visited a medical specialist ≥ 5 times, and 66/116 (56.9%) missed work in the 24 months prior to baseline, and 17/166 (11.6%) changed employment status or retired prematurely due to disease burden. Prior treatment consisted of surgery (i.e., arthroscopic, open synovectomy) (128/166; 77.1%), and systemic treatments (52/166; 31.3%) with imatinib (19/52; 36.5%) or pexidartinib (27/52; 51.9%). Treatment strategies at baseline visits consisted mainly of watchful waiting (81/166; 48.8%), surgery (41/166; 24.7%), or targeted systemic therapy (37/166; 22.3%). Patients indicated for treatment reported more impairment compared to patients indicated for watchful waiting: worst stiffness NRS 5.16/3.44, worst pain NRS 6.13/5.03, PROMIS-PF 39.48/43.85, and EQ-5D VAS 66.54/71.85.Conclusion: This study confirms that diffuse-type TGCT can highly impact quality of life. A prospective observational registry in rare disease is feasible and can be a tool to collect curated-population reflective data in orphan diseases.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

The diffuse-type tenosynovial giant cell tumor (dt-TGCT) patient journey: a prospective real-world study

Bernthal¹,

Spierenburg²,

Healey³

et al. 2020

Preprint

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“…Though Dt-GCT is usually managed with open synovectomy, while arthroscopic synovectomy is usually indicated in localized GCT, no consensus about the treatment strategies has been reached. Most recently, Noailles T and his colleagues [ 32 ] reviewed the literature about open surgery or arthroscopic synovectomy for GCT-TS in 2017, 33 articles were selected in this review, involving 1448 individuals. They concluded that arthroscopic excision was effective for localized GCT-TS for all four joints (shoulder, hip, knee, ankle).…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment for diffused-type giant cell tumor (pigmented villonodular synovitis) about the ankle joint

Zhu

et al. 2017

BMC Musculoskelet Disord

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BackgroundDiffused-type giant cell tumor(Dt-GCT) is a rare, aggressive disorder of the joint synovium, bursa and tendon sheaths. Osseous erosions and subchondral cysts may develop as the result of synovium infiltration in Dt-GCT. We present a retrospective study of a series of patients who are diagnosed with Dt-GCT about the ankle joint, there clinical outcome is evaluated in this study.Material and methodFifteen patients with radiologically and histologically confirmed Dt-GCT about the ankle joint were identified in our foot and ankle department. Patients were managed with open synovectomy for the tumor tissue and bone grafting for bony erosions. X-rays and MRI scans were used for evaluation of the tumor and bony erosions pre- and post-operatively. Pre- and post-operative ankle function was assessed using the American Orthopedic Foot and Ankle Society –Ankle and Hindfoot (AOFAS-AH) score and the Muscularskeletal Tumor Society (MSTS) score.ResultsThe mean follow-up duration was 37.4 months (range 25 to 50 months). There were 6 males and 9 females, with a mean age of 35 years old (range 18 to 65 years). All patients had talar erosion with the average size of 10.1*9.1*8.2 mm, distal tibia was affected in 5 patients with the average size of 6.2*5.6*5.8 mm. 7 patients had tendon involvement, 2 patients had recurrence and progression of ankle osteoarthritis. Both of them underwent ankle fusion. At the time of last follow-up, the mean AOFAS-AH score increased from 49 to 80 points (p < 0.05), the MSTS score increased from 12 to 22 points (p < 0.05).ConclusionFor Dt-GCT with bony erosions, open synovectomy combined with bone grafting seems to be a safe and effective operation for the salvage of ankle joint. Fusion is recommended for failed and severe cartilage destruction of the ankle joint.

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“…TKDHT'nin tedavisi eklem destrüksiyonunu sınırlamak için erken dönemde yapılan cerrahi eksizyondur. 1 Total eksizyon, tümörün tedavisini ve nüks riskinin azaltılmasını sağlamaktadır. Prognozu iyidir ama rekürens riski yüksektir.…”

Section: Parmakta Travma Sonrasıunclassified

Posttraumatic Nodular Lesion at Finger: Giant Cell Tumor of Tendon Sheath

Baştuğ¹,

Duman²,

Özdemir³

2019

Turkiye Klinikleri J Dermatol

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endon kılıfının dev hücreli tümörü (TKDHT); eklem, bursa veya tendon kılıfı sinoviyumunun benign, lokal agresif, proliferatif bir hastalığıdır. 1 En sık olarak el palmar yüzde nodüler kitle ile kendini göstermektedir. Dermoskopisi ile ilgili literatür bilgisi oldukça azdır.Bu çalışmada, TKDHT'nin dermoskopik ve histopatolojik özelliklerine ve ayırıcı tanısına dikkat çekilmesi amaçlanmıştır. OLGU SUNUMUOtuz üç yaşındaki erkek olgu, son dört aydır parmakta oluşan şişlik şikâyeti ile başvurdu. Hastadan bilgilendirilmiş onam formu alındı. Öyküsünden lezyonun ağrısız olduğu ve geçirdiği trafik kazası sonrası ortaya çıktığı öğrenildi. Dermatolojik muayenesinde sol el üçüncü parmak palmar yüzde 0,7x0,6 cm çaplı, sarımsı beyaz renkte, üzerinde yer yer telenjiektazilerin izlendiği, mobil olmayan sert nodüler lezyon görüldü (Resim 1). Nodülün dermoskopik incelemesinde, beyaz skar benzeri yapısız zeminde yer yer Turkiye Klinikleri J Dermatol. 2019;29(2):89-91 89 Re ce i ved:

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Giant cell tumor of tendon sheath: Open surgery or arthroscopic synovectomy? A systematic review of the literature

Abstract: Review of literature, level of evidence IV.

Cited by 43 publications

References 63 publications

The diffuse-type tenosynovial giant cell tumor (dt-TGCT) patient journey: a prospective real-world study

The diffuse-type tenosynovial giant cell tumor (dt-TGCT) patient journey: a prospective real-world study

Surgical treatment for diffused-type giant cell tumor (pigmented villonodular synovitis) about the ankle joint

Posttraumatic Nodular Lesion at Finger: Giant Cell Tumor of Tendon Sheath

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