Download PDF
J Hand Microsurg 2020; 12(S 01): S50-S53
DOI: 10.1055/s-0039-1679102
Case Report

Giant Cell Tumor of Tendon Sheath Developed over Chimeric-Free Latissimus Dorsi and Serratus Anterior Muscle Flaps

Athanasios Karonidis
1   Department of Plastic Surgery, Microsurgery, Burns Unit and Reference Centre for Melanoma, General Hospital of Athens “G. Gennimatas,” Athens, Greece
,
Akrivi Kostopoulou
2   Department of Pathology, General Hospital of Athens “G. Gennimatas,” Athens, Greece
,
Sofia Pappa
2   Department of Pathology, General Hospital of Athens “G. Gennimatas,” Athens, Greece
,
Dimosthenis Tsoutsos
1   Department of Plastic Surgery, Microsurgery, Burns Unit and Reference Centre for Melanoma, General Hospital of Athens “G. Gennimatas,” Athens, Greece
› Author Affiliations Funding None.
› Further Information
    Permissions and Reprints

Abstract

This article describes a rare case of giant cell tumor of the tendon sheath (GCTTS) that was developed over the substance of chimeric-free latissimus dorsi and ­serratus ­anterior muscle flaps performed for lower limb reconstruction. To our knowledge, development of GCTTS over a free flap is first described in the literature. A 71-year-old ­woman was presented with a large protuberant ulcerated tumor mass that was developed over the substance of chimeric free muscle flaps at the foot and ankle. We performed an extensive tumor resection, and the pathology report confirmed the presence of a primary giant cell tumor. The patient was advised to have a below-knee amputation. However, the patient refused the amputation, and 4 months later, she was presented with a metastatic mass proximally at the upper thigh. We believe that the GCTTS was associated with the chronic inflammation of the soft tissue and bones along with the recurrent episodes of infection, mainly due to proteus mirabilis and proteus syndrome (PS). PS may lead to the development of malformations and overgrowth of different tissues in unusual locations. In cases resistant to antibiotics, the radical surgical debridement should be considered as the most effective treatment.

Keywords

giant cell tumor of tendon sheath - proteus syndrome - chimeric-free flap - microsurgery


Publication History

Article published online:
25 February 2019

© .

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Gibbons CL, Khwaja HA, Cole AS, Cooke PH, Athanasou NA. Giant-cell tumour of the tendon sheath in the foot and ankle. J Bone Joint Surg Br 2002; 84 (07) 1000-1003
    CrossrefPubMedGoogle Scholar
  • 2 Vogrincic GS, O’Connell JX, Gilks CB. Giant cell tumor of tendon sheath is a polyclonal cellular proliferation. Hum Pathol 1997; 28 (07) 815-819
    CrossrefPubMedGoogle Scholar
  • 3 Hosaka M, Hatori M, Smith R, Kokubun S. Giant cell formation through fusion of cells derived from a human giant cell tumor of tendon sheath. J Orthop Sci 2004; 9 (06) 581-584
    CrossrefPubMedGoogle Scholar
  • 4 Jaffe HL, Lichtenstein HL, Elsutro CJ. Pigmented ­villonodular synovitis, bursitis, and tenosynovitis. Arch Pathol (Chic) 1941; 31: 731-765
    PubMedGoogle Scholar
  • 5 Goni V, Gopinathan NR, Radotra BD, Viswanathan VK, Logithasan RK, S. B. Giant cell tumour of peroneus brevis tendon sheath—a case report and review of literature. BMJ Case Rep 2012; 2012: bcr0120125703
    CrossrefPubMedGoogle Scholar
  • 6 Vargaonkar G, Singh V, Arora S. et al. Giant cell tumor of the tendon sheath around the foot and ankle. a report of three cases and a literature review. J Am Podiatr Med Assoc 2015; 105 (03) 249-254
    CrossrefPubMedGoogle Scholar
  • 7 Monaghan H, Salter DM, Al-Nafussi A. Giant cell tumour of tendon sheath (localised nodular tenosynovitis): clinicopathological features of 71 cases. J Clin Pathol 2001; 54 (05) 404-407
    CrossrefPubMedGoogle Scholar
  • 8 Vasconez HC, Nisanci M, Lee EY. Giant cell tumour of the flexor tendon sheath of the foot. J Plast Reconstr Aesthet Surg 2008; 61 (07) 815-818
    CrossrefPubMedGoogle Scholar
  • 9 Kotwal PP, Gupta V, Malhotra R. Giant-cell tumour of the ­tendon sheath. J Bone Joint Surg Br 2000; 82 (04) 571-573
    CrossrefPubMedGoogle Scholar
  • 10 Reilly KE, Stern PJ, Dale JA. Recurrent giant cell tumors of the tendon sheath. J Hand Surg Am 1999; 24 (06) 1298-1302
    CrossrefPubMedGoogle Scholar
  • 11 Cohen Jr MM. Proteus syndrome review: molecular, clinical, and pathologic features. Clin Genet 2014; 85 (02) 111-119
    CrossrefPubMedGoogle Scholar
  • 12 Lougaris V, Salpietro V, Cutrupi M. et al. Proteus syndrome: evaluation of the immunological profile. Orphanet J Rare Dis 2016; 11: 3
    CrossrefPubMedGoogle Scholar