Giant cell tumor of the tendon sheath with intraosseous phalangeal invasion: a case report and review of the literature

Giant cell tumor of the tendon sheath with intraosseous phalangeal involvement

“…2,9,11,18,19 Uriburu and Levy 11 noted cortical perforation and intraosseous expansion in 11% of 133 patients. In a series of 200 consecutive osseous (pseudo) tumors of the hand reported by De Schepper et al, 19 six patients had intrinsic osseous lesions caused by a histologically confirmed neighboring GCTTS.…”

“…7,8 GCTTS that occur in the hand may compress adjacent osseous surfaces with presentation on radiographs of bony indentation or atrophy; intraosseous invasion is relatively rare. 2,[9][10][11] Radiographic changes are observed in 11-70% patients. 1,2,11,12 Rao and Vigorita, 12 in a review of 81 patients with GCTTS of the fingers or thumb, reported soft-tissue swelling in 34%, bone erosion in 9%, and both soft-tissue swelling and erosion in 17%.…”

“…MRI obtained in four patients showed the extraosseous tumor invading and eroding bone and causing cortical scalloping (three and one patients, respectively). In our patient, we observed scalloping and intraosseous extension on CT. Choughri et al 2 reported intraosseous involvement of the metaphyseal base of the distal phalanx, as well as, the entire proximal middle phalanx. Lu et al 18 reported intraosseous invasion of GCTTS in the form of multiple osteolytic cystic cavities in the shaft of middle phalanx of index finger, and Fogelson et al 20 reported intraosseous metacarpal involvement in two patients.…”

“…21 The mechanism of bone penetration is still not clear. Scott 22 believed that the GCTTS reaches the medullary canal through the vascular foramina of the bones, while Choughri et al 2 and Phalen et al 23 observed direct penetration of the bone through the cortex. We also observed direct invasion of the cortex without periosteal reaction, bony enlargement, or a cortical window through the phalanx in our patient, although there was scalloping of the bone.…”

Giant cell tumour of tendon sheath with bone invasion in extremities: analysis of clinical and imaging findings

“…Therefore, a reliable preoperative localization and qualitative diagnosis are necessary, and an appropriate preoperative differential diagnosis has become an important issue. To the best of our knowledge, the previous literatures concerning GCTTS with bone invasion included only a small amount of patients with limited radiographic evaluation or principally reviewed from a clinical and/or therapeutic perspective, and most of them were case reports [1,[9][10][11][12][13][14][15][16]. Therefore, clinical and radiological characteristics of GCTTS with bone invasion are yet to be clarified.…”