Giant Cell Tumour of Extensor Tendon Sheath in the Hand–A Case Report and Strategies to Prevent Recurrence

Aims: Giant cell tumour of tendon sheath (GCTTS) was first described by Chassaignac back in 1852 as a rare benign tumour of uncertain aetiology. GCTTS is a painless slow growing benign tumour that develops over period of months to years. They present a surgical dilemma due to their high incidence of recurrence.

Presentation of Case: A 50 years old Malay lady presented to us with left middle finger pain and swelling for 4 months which was slowly increasing in size. She was diagnosed with giant cell tumour of left middle finger proximal phalanx and underwent excision biopsy and on regular follow up to monitor for any recurrence. So far after one year of follow up there is no recurrence of the disease.

Discussion: Giant cell tumour of tendon sheath (GCTTS) is a locally aggressive, proliferative disorder of the synovium involving a joint, bursa or tendon sheath. Surgery remains the primary treatment of choice for GCTTS. However, surgery alone in GCTTS has high recurrence rate of as high as 30%. We will discuss on strategies to prevent recurrence of this condition.

Conclusion: Every effort should be made to have complete excision of tumour without leaving behind satellite lesions and bony erosions should be thoroughly curetted to reduce the risk of recurrence. Patient may also be offered the benefit of radiotherapy if the excised specimen shows evidence of mitosis or if the excision is less than complete. Patients with these risk factors should be offered regular follow up for up to five years to make sure that any recurrences are identified early.