Abstract
Recurrence of Giant cell tumor of the tendon sheath (GCTTS) is an unresolved issue,
though it is a non malignant condition. The authors operated on fourteen cases of
GCTTS, after fine needle aspiration cytology confirmation and using a magnifying loupe
for complete excision of the lesion including the satellite nodules. In only one case
recurrence was noted which was successfully managed by a second wide excision. Preoperative
diagnosis and meticulous surgical technique were found the only predictive factor
of recurrence. During the 5 year period from 2002, 12 patients [11 females, 1 male,
mean age 29.5, ranging from 10–53 years] underwent excision of giant cell tumor of
tendon sheath of the hand. The lesions were found over the thumb [n = 7], ring finger [n = 1], index finger [n = 1], and over the hand [n = 2]. The lesions were classified using the Al-Qattan classification. The most common
presentation was with a mass over the hand, with a predilection to the thumb [n = 7]. Radiological changes in the form of bony indentation was seen in only 2 cases.
FNAC was inconclusive in 2 out of the 12 cases. Due to the high incidence of recurrence,
pre-operative planning aided by a tissue diagnosis with fine needle aspiration cytology,
wide surgical exposure, and meticulous dissection with help of magnification are imperative
for a successful outcome in GCTTS.
Keywords
Hand - Tendon sheath - Giant cell tumor - Recurrence
