Garg Bhavuk, Kotwal Prakash P
Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
J Orthop Surg (Hong Kong). 2011 Aug;19(2):218-20. doi: 10.1177/230949901101900218.
To review outcomes of 106 patients after complete excision of the giant cell tumour of the tendon sheath of the hand, with or without postoperative radiotherapy.
Records of 77 women and 29 men aged 11 to 61 (mean, 31) years who underwent excision of giant cell tumours of the tendon sheath of the hand were reviewed. All patients presented with gradually progressive swelling; only 3 of them also presented with pain. The lesions were located on the dorsal aspect (n=11), the palmar aspect (n=66), both aspects (n=10), or circumferentially (n=14). No patient had multiple lesions. Five patients had bony erosion and 3 had neurovascular bundle involvement.
The mean follow-up period was 12 (range, 4-22) years. 56 patients with well-encapsulated giant cell tumour in the palmer and/or dorsal aspects were classified as at low risk of recurrence. The remaining 50 patients were classified as at high risk of recurrence and underwent postoperative radiotherapy. None of the patients at low risk had any recurrence; 4 of those at high risk had recurrence despite radiotherapy. No complication was attributable to the irradiation, except that 3 patients had some dark pigmentation around the wound scar.
Postoperative radiotherapy may have a role in reducing recurrence of the giant cell tumour of the tendon sheath of the hand.
回顾106例手部腱鞘巨细胞瘤完整切除术后的结果，无论是否接受术后放疗。
回顾了77例女性和29例男性患者的记录，年龄在11至61岁（平均31岁），他们均接受了手部腱鞘巨细胞瘤切除术。所有患者均表现为逐渐进展的肿胀；其中只有3例还伴有疼痛。病变位于背侧（n = 11）、掌侧（n = 66）、双侧（n = 10）或环状（n = 14）。没有患者有多个病变。5例患者有骨质侵蚀，3例患者有神经血管束受累。
平均随访期为12年（范围4至22年）。56例在掌侧和/或背侧有完整包膜的腱鞘巨细胞瘤患者被归类为复发风险低。其余50例患者被归类为复发风险高，并接受了术后放疗。低风险组患者均无复发；高风险组中有4例患者尽管接受了放疗仍复发。除3例患者伤口瘢痕周围有一些色素沉着外，没有并发症可归因于放疗。
术后放疗可能在降低手部腱鞘巨细胞瘤的复发方面发挥作用。
