# Tenosynovial Giant Cell Tumors in the Hand and Foot

## TL;DR

This study examines the characteristics and outcomes of giant cell tumors in the hand and foot, finding that most occur in the hand and that complete surgical removal is key to preventing recurrence.

## Contribution

The study provides a detailed analysis of the anatomic distribution and clinical outcomes of GCTTS in the hand and foot based on a large case series.

## Key findings

- The majority of GCTTS cases occurred in the upper extremity with a 12:1 hand-to-foot ratio.
- Recurrence was observed in 6.4% of cases following surgical excision.
- MRI and plain radiographs were essential for accurate diagnosis and treatment planning.

## Abstract

Background: Giant cell tumor of the tendon sheath (GCTTS) is one of the most common benign, slow-growing soft tissue tumors of the hand and foot. This study aimed to evaluate the anatomic distribution of the GCTTS and correlate the surgical treatment with clinical outcomes and recurrence rates.

Methods: In this retrospective study, a total of 78 cases of GCTTS of the hand and foot operated from January 1, 2003 to December 31, 2020, with anatomopathological confirmation of diagnosis, were included. Patients were investigated with plain radiographs of the involved anatomic area and magnetic resonance imaging (MRI). All tumors were excised under regional anesthesia, tourniquet control, and magnifying loupes.

Results: The most frequent symptom at admission was a painless, mobile, and lobulated subcutaneous mass, which gradually increased in size. The average time period between the onset of the symptoms and the clinical evaluation was 5.6 months. The study contained 30 male and 48 female patients, and the average age was 46.31 years. The tumor was located on the upper extremity in the majority of cases (92.3%) with a 12:1 hand-to-foot proportion. Of the lesions, 22.23% were located in the thumb, 20.82% in the second digit, 16.75% in the third digit, 11.12% in the fourth digit, and 20.82% in the fifth digit. Around 50% of foot lesions were located in the hallux. According to the pathology reports, the mean dimension of hand tumors was 1.2 cm at the greatest axis, and of the foot tumors, it was 3.3 cm. There was no significant correlation between the anatomic distribution of GCTTS, gender, age, size of the tumor, and recurrence rates. Recurrence was noted in five cases (6.4%).

Conclusion: Accurate imaging of GCTTS with MRI and plain radiographs, followed by radical excision of the lesion, is fundamental for minimizing recurrence potential, which should be underlined to the patient.