El ve El Bileği Yerleşimli Tendon Kılıfının Dev Hücreli Tümörü: 42 Hastanın Retrospektif Analizi

Year 2019, Volume: 45 Issue: 1, 105 - 109, 01.04.2019

Sercan Çapkın , Tufan Kaleli

https://doi.org/10.32708/uutfd.491010

Abstract

Tendon kılıfının dev hücreli tümörü (TKDHT),
ganglion kistinden sonra elde en sık görülen benign yumuşak doku tümörüdür.
Çalışmamızda el ve el bileği yerleşimli TKDHT nedeniyle ameliyat edilen 42
hastanın demografik, klinik, radyolojik ve histopatolojik özellikleri ile
cerrahi sonrası nüks oranları güncel literatür eşliğinde tartışıldı.
Çalışmamızda; kadın/erkek oranı: 2.5/1, ortalama yaş 40.23±14.86, hastaların
%64.28’ inde tümör volar bölgeye lokalize, 
elde en sık lokalizasyon başparmak (%33.3), parmaklarda ise en sık
lokalizasyon proksimal falanks (%35,71) olup, bulgular literatür verileriyle
uyumluydu. Serimizde şikayetin başlangıcından cerrahiye kadar geçen ortalama
zaman 5.4 ay olarak bulundu. Nüks gelişen 2 hastada (%4.76) tümör volar
bölgeden başlayıp dorsal bölgeye doğru uzanmaktaydı ve muhtemel nüks nedeni
geride satellit lezyon kalmasıydı. Sonuç olarak TKDHT benign karakterine rağmen
lokal agresif bir tümördür. Nüks oranlarını azaltmak için büyütücü gözlük
altında, geniş bir cerrahi sahada, titiz bir cerrahi uygulanmalı, özellikle hem
volar hem de dorsal bölgeye lokalize olan tümörlerde geride satellit lezyon
bırakmamak için ayrı insizyonlar kullanılması akılda bulundurulmalıdır.

Keywords

Tendon kılıfı, Dev hücreli tümör

Giant Cell Tumour of the Tendon Sheath of the Hand and Wrist: Retrospective Analysis of 42 Patients

Abstract

Giant cell tumour of the tendon sheath (GCTTS)
is the second most common benign soft tissue tumour of the hand after the
ganglion cyst. In our study, demographic, clinical, radiological and
histopathological features and recurrence rates of 42 patients who had been
operated for hand and wrist located GCTTS were discussed with the current
literature. In our study; female/male ratio: 2.5/1, average age 40.23±14.86,
64.28% of patients localized to the tumour volar side, the most common
localization thumb (33.3%) in the hand, the most common localization of the
proximal phalanx in the fingers (35.71%), findings were consistent with
literature data. In our series, the average time from the beginning of the
complaint to surgery was found to be 5.4 months. In 2 patients (4.76%) who
developed recurrence, the tumours started from the volar side was reaching to
the dorsal side, and the reason for the possible recurrence was the remaining
satellite lesions. As a result, GCTTS is a locally aggressive tumour despite
its bening character. To reduce the recurrence rate, a meticulous surgery
should be performed under magnifying loupe, in a large surgical area,
especially in tumours that are localized to both the volar and dorsal sides,
and separate incisions should be considered in order not to leaving behind
satellite lesions.

Keywords

Tendon sheath, Giant cell tumour

References

• 1. Darwish FM, Haddad WH. Giant cell tumour of tendon sheath: experience with 52 cases. Singapore Med J Original 2008; 49(11): 879-82.
• 2. Fotiadis E, Papadopoulos A, Svarnas T, Akritopoulos P, Sachinis NP, Chalidis BE. Giant cell tumour of tendon sheath of the digits. A systematic review. Hand 2011;6(3):244-9.
• 3. Chassaignac M. Cancer de la gaine des tendons. Gazette Hop Civils Mil 1852;47:185-6.
• 4. Targett JH. Giant cell tumors of the integument. Trans Pathol Soc Lond 1897;48:230-5.
• 5. Jaffe HL, Lichtenstein L, Sutro CJ: Pigmented villonodular synovitis, bursitis and tenosynovitis: A discussion of the synovial and bursal equivalents of the tenosynovial lesions commonly denoted as xanthoma, xanthogranuloma, giant cell tumor, or myeloplaxoma of the tendon sheath, with some consideration of this tendon sheath lesion itself. Arch Pathol 1941;31:731-65.
• 6. Jones FE, Soule EH, Coventry MB. Fibrous xanthoma of synovium (giant-cell tumor of tendon sheath, pigmented nodular synovitis). J Bone Joint Surg Am 1969;51(1):76-86.
• 7. Moore JR, Weiland AJ, Curtis RM. Localized nodular tenosynovitis: experience with 115 cases. J Hand Surg 1984;9(3):412-7.
• 8. Al-Qattan MM. Giant cell tumors of tendon sheath: classification and recurrence rate. J Hand Surg Br 2001;26(1):72-5.
• 9. Flandry F, Hughston JC. Pigmented villonodular synovitis. J Bone Joint Surg Am 1987;69(6):942-9.
• 10. Froimson AI. Benign solid tumors. Hand Clinics 1987;3(2): 213-7.
• 11. Glowacki KA, Weiss APC. Giant cell tumors of tendon sheath. Hand Clinics 1995;11(2): 245-53.
• 12. Hansen P, Nielsen PT, Wahlin AB. Pigmented villonodular synovitis of the extensor tendon sheaths in a child. Journal of Hand Surg Br 1988;13(3):313-4.
• 13. Byers PD, Cotton RE, Deacon OW et al. The diagnosis and treatment of pigmented villonodular synovitis. Journal of Bone and Joint Surg Br 1968;50(2):290-305.
• 14. Rao AS, Vigorita VJ. Pigmented villonodular synovitis (giant cell tumor of the tendon sheath and synovial membrane). A review of eighty-one cases. J Bone Joint Surg Am 1984;66(1):76-94.
• 15. Reilly KE, Stern PJ, Dale JA. Recurrent giant cell tumors of the tendon sheath. J Hand Surg Am 1999;24(6):1298-302.
• 16. Briet JP, Becker SJ, Oosterhoff Tch, Ring D: Giant cell tumor of tendon sheath. Arch Bone Jt Surg 2015; 3(1):19-21.
• 17. Glowacki KA. Giant cell tumors of tendon sheath. J Hand Surg Am 2003;3(2):100-7.
• 18. Rukavina I, Caleta D. Giant-cell tumour of the tendon sheath: A review. OA Orthopaedics. 2014;2(2):11.
• 19. Monaghan H, Salter DM, Al-Nafussi A. Giant cell tumor of tendon sheath (localised nodular tenosynovitis): clinicopathological features of 71 cases. J Clin Path 2001;54(5):404-7.
• 20. Adams EL, Yoder EM, Kasdan ML. Giant cell tumour of tendon sheath: experience with 65 cases. Eplasty 2012;12: 423-30.
• 21. Ozalp T, Yercan H, Kurt C, Ozdemir O, Coskunol E. Giant-cell tumors of the tendon sheath involving the hand or the wrist: an analysis of 141 patients. Acta Orthop Traumatol Turc 2004;38(2):120-4.
• 22. Karasick D, Karasick P. Giant cell tumor of the tendon sheath: spectrum of radiological findings. Skeletal Radiol 1992;21(4):219-24.
• 23. Booth KC, Campbell GS, Chase DR. Giant cell tumor of tendon sheath with intraosseous invasion: a case report. J Hand Surg Am 1995;20(6):1000-2.
• 24. Sherry CS and Harms SE. MR evaluation of giant cell tumors of the tendon sheath. Magn Reson Imaging 1989;7(2): 195-201.
• 25. Walsh EF, Mechrefe A, Akelman E, Schiller AL. Giant cell tumor of tendon sheath. Am J Orthop (Belle Mead NJ) 2005;34(3):116-21.
• 26. Suresh SS, Zaki H. Giant cell tumor of tendon sheath: case series and review of literature. J Hand Microsurg 2010;2(2):67-71.
• 27. Ushijima M, Hashimoto H, Tsuneyoshi M, Enjoji M. Giant cell tumour of the tendon sheath (nodular tenosynovitis): A study of 207 cases to compare the large joint group with the common digit group. Cancer, 1986;57(4):875-84.
• 28. Kotwal PP, Gupta V, Malhotra R. Giant cell tumour of the tendon sheath. Is radiotherapy indicated to prevent recurrence after surgery? J Bone Joint Surg 2000;82(4):571-3.
• 29. Ikeda K, Osamura N, Tomita K. Giant cell tumour in the tendon sheath of the hand: importance of the type of lesion. Scand J Plast Reconstr Surg Hand Surg 2007;41(3):138-42.
• 30. Jalgaonkar A, Dhinsa B, Cottam H, Mani G. Giant cell tumours of tendon sheath of hand: causes and strategies to prevent recurrence. Hand Surg 2011;16(2):149-54.