Chen Y U, Yu Xiu-Chun, Xu Song-Feng, Wang Bing
Department of Orthopaedic Surgery, General Hospital of Jinan Military Region, Jinan, Shandong 250031, P.R. China.
Oncol Lett. 2016 May;11(5):3461-3464. doi: 10.3892/ol.2016.4377. Epub 2016 Mar 24.
Giant cell tumor of the tendon sheath (GCTTS), also termed tendosynovial giant cell tumor, is a benign, slow-growing tumor that originates from the tendon sheath or bursa. GCTTS of the foot and ankle is much less frequently reported compared with GCTTS of the hand and knee. However, GCTTS should be considered as a differential diagnosis of soft tissue tumors of the foot and ankle. The optimal treatment strategy for GCTTS in the foot and ankle is controversial due to a scarcity of cases. The present study reports the case of a patient that presented with localized intra-articular GCTTS originating from the capsule of the ankle, which is a rare anatomical location for this tumor. Considering the proximity of the tumor to the adjacent non-tumorous structures, a less radical but complete resection of the tumor was performed, followed by a hydrogen peroxide lavage. There was no evidence of recurrence during a follow-up period of 12 months, and adjuvant radiotherapy was not administered to the patient. A pre-operative diagnosis for GCTTS in the foot and ankle is mainly based on the findings of clinical examination and magnetic resonance imaging, which also facilitates the determination of a surgical strategy. For a localized tumor, an integral resection, as opposed to a radical resection, with a hydrogen peroxide lavage may result in a favorable prognosis. However, the optimal treatment for diffuse GCTTS remains to be identified.
腱鞘巨细胞瘤(GCTTS),也称为肌腱滑膜巨细胞瘤,是一种起源于腱鞘或滑囊的良性、生长缓慢的肿瘤。与手和膝关节的腱鞘巨细胞瘤相比,足踝部腱鞘巨细胞瘤的报道要少得多。然而,腱鞘巨细胞瘤应被视为足踝部软组织肿瘤的鉴别诊断之一。由于病例稀少,足踝部腱鞘巨细胞瘤的最佳治疗策略存在争议。本研究报告了一例患者,该患者表现为起源于踝关节囊的局限性关节内腱鞘巨细胞瘤,这是该肿瘤罕见的解剖位置。考虑到肿瘤与相邻非肿瘤结构的接近程度,对肿瘤进行了不太激进但完整的切除,随后用过氧化氢冲洗。在12个月的随访期内没有复发迹象,且未对该患者进行辅助放疗。足踝部腱鞘巨细胞瘤的术前诊断主要基于临床检查和磁共振成像的结果,这也有助于确定手术策略。对于局限性肿瘤,与根治性切除相反,采用过氧化氢冲洗的完整切除可能会带来良好的预后。然而,弥漫性腱鞘巨细胞瘤的最佳治疗方法仍有待确定。