Wang Yanjun, Zhu Xiaoxiao, Pei Genwang, Zeng Xianshang, Chen Deng, Zuo Yonggang, Yu Weiguang, Ge Zhe, Zhang Xinchao
1 Department of Rehabilitation Medicine, The First Affiliated Hospital of Sun Yat-sen University, Huangpu District, Guangzhou, Guangdong Province, China.
*These authors contributed equally to this work.
J Int Med Res. 2018 Mar;46(3):1263-1270. doi: 10.1177/0300060517735935. Epub 2017 Nov 3.
Giant-cell tumour of the tendon sheath (GCTTS) is a soft tissue tumour that may invade bone, causing an intrinsic osseous lesion or instability on radiographs. A case with scaphoid instability caused by a histologically-confirmed neighbouring GCTTS has rarely been described in the literature. No definite and radical method is available for the treatment of GCTTS. This report describes an unusual case of a 22-year-old woman who previously experienced a GCTTS in her right elbow, which was removed 10 years earlier. Currently, she presented with an enlarged painless right wrist mass with focal swelling. The mass has been present for 5 years. During the previous 6 months, she felt something pop and experienced pain with limited motion in her right wrist. Magnetic resonance imaging demonstrated a well-circumscribed soft tissue mass. Under general anaesthesia, complete surgical resection of the mass was undertaken. Histopathological examination revealed that the mass was a GCTTS. Less invasive leverage reduction with external fixator support and iliac crest bone autologous graft for treatment of carpal instability were performed. Radical resection combined with external fixator support and bone grafting can provide a new option for the treatment of carpal instability.
腱鞘巨细胞瘤（GCTTS）是一种软组织肿瘤，可侵犯骨骼，在X线片上导致骨内病变或不稳定。文献中很少描述由组织学确诊的相邻GCTTS引起舟骨不稳定的病例。目前尚无明确且彻底的方法治疗GCTTS。本报告描述了一例不寻常的病例，一名22岁女性，10年前曾因右肘GCTTS接受手术切除。目前，她右腕出现无痛性肿块且局部肿胀，肿块已存在5年。在过去6个月里，她感觉有东西弹出，并伴有右腕疼痛及活动受限。磁共振成像显示为边界清晰的软组织肿块。在全身麻醉下，对肿块进行了完整的手术切除。组织病理学检查显示该肿块为GCTTS。采用外固定器辅助下的微创杠杆复位及自体髂骨移植治疗腕关节不稳定。根治性切除联合外固定器辅助及植骨可为腕关节不稳定的治疗提供新的选择。
