Clinicopathological Profile of Giant Cell Tumor of Tendon Sheath: A Case Series of Four Patients

Giant cell tumors of tendon sheath (GCTTS), now designated localized tenosynovial giant cell tumor by WHO, is a benign proliferative lesion arising from tendon sheaths, bursae or joints. Among soft tissue tumors of the hand, ganglion cysts are more frequent; foot involvement is rare and can complicate diagnosis. Lesions affected both hand and foot: two lesions were in the left thenar region and little finger and two in right great toe and left third toe. Symptoms had varied in duration from two months to four years. Two patients underwent MRI which showed well defined lobulated soft tissue lesions originating from tendon sheaths. All four patients underwent complete marginal excision. Histopathology confirmed the diagnosis: mononuclear stromal cells mixed with foamy histiocytes, hemosiderin laden macrophages and multinucleated osteoclast like giant cells were seen in all cases. At 12 months review none of the patients show symptoms or clinical signs of recurrence. Soft tissue swelling that grows slowly warrants GCTTS as a diagnosis to consider. Short term outcomes are excellent when complete margins are excised along with histopathological confirmation.