El Yerleşimli Tendon Kılıfı Dev Hücreli Tümör: 35 Hastanın Değerlendirilmesi

Abstract

Giant-cell Tumor of Tendon Sheath of Hand; Evaluation of 35 Patient We have retrospectively evaluated tendon sheath giant cell tumors regarding their complications at the time of diagnosis, during treatment period and at postoperative period. We have performed surgery to 35 patients for their tendon sheath giant cell tumors localized in their hands [20 females, 15 males, mean age was 46.6 (17-72)]. Localization of the tumor was on the right hand side in 21 of the cases and on the left in 14 of the cases. Mean follow up time was 3.1 years (8 months-9.4 years). Most common complaints of the patients was a painless soft tissue mass. They were mostly on the volar side (%72) and on index finger (%25) and they were frequently found to be localized at the proximal phalanx (%51). The duration of the symptoms was between 3 months and 2.5 years. Bony involvement was found in 2 cases. At the postoperative period we have found digital nerve injury in 5 of the cases, superficial skin infection in 3 of the cases. We have found recurrence in 12 of the cases (%34.2) in a mean time of 2.8 years and joint stiffness was found in 8 of the cases. Tendon sheath giant cell tumors have high recurrence rates so surgery should be performed meticulously in a wide surgical field and magnifying glasses should be worn. Eldeki tendon kılıflarında gelişen tendon kılıfı dev hücreli tümörleri tanı, tedavi ve ameliyat sonrası dönemde oluşan komplikasyonlar açısından retrospektif olarak değerlendirildi. On beş yıllık bir dönem içinde, el yerleşimli tendon kılıfı dev hücreli tümör nedeniyle 35 hastaya [20 kadın, 15 erkek, ortalama yaş 46,6 yıl (17-72)] Ondokuzmayıs Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji AD tarafınca cerrahi uygulandı. Lezyonların hepsi el yerleşimliydi. Tutulum 21 olguda sağ, 14 olguda sol tarafta idi. Ortalama izlem süresi 3.1 yıl (8 ay- 9,4 yıl) idi.Hastaların en sık başvuru nedeni ağrısız yumuşak doku kitlesi idi. Olguların çoğunda (%71,4) tümör volar bölgeden kaynaklanmıştı. Tümör sıklıkla işaret parmağında (%25,7), ve proksimal falanks düzeyinde (%51,4) gelişmişti. Bulguların süresi 3 ay ile 2,5 yıl arasında değişmekteydi. 2 olguda kemik tutulumu gözlendi. Ameliyat sonrası dönemde 5 olguda digital sinir hasarı, 3 olguda yüzeyel enfeksiyon, 8 olguda eklem sertliği gelişti. 12 hastada (%34,3) ortalama 2,8 yıl içinde (2 ay -5 yıl) nüks oldu.Tendon kılıfının dev hücreli tümörlerinde yüksek nüks oranı göz önüne alınarak, geniş cerrahi sahada titiz bir cerrahi uygulanmalı ve büyütücü gözlüklerden yararlanılmalıdır.

Keywords

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