Kant Kumar Shashi, Manav Ajoy Kumar, Kumar Rakesh, Sinha Vishvendra Kumar, Sharma Akshat
Department of Orthopaedics, Patna Medical College, Patna, India.
Department of Orthopaedics, Lady Hardinge Medical College, New Delhi, India.
J Clin Orthop Trauma. 2017 Nov;8(Suppl 2):S96-S99. doi: 10.1016/j.jcot.2017.06.014. Epub 2017 Jun 15.
Aim of our study is to highlight the incidence and benign nature of Giant cell tumour of tendon sheath and need for complete removal, thus minimizing the chances of recurrence.
A total of 26 cases of Giant cell tumour of tendon sheath operated in the department of Orthopaedics, Patna Medical College & Hospital, Patna from 2003 to 2010 were included in this study. The surgery was performed after clinical evaluation of the lesion and Fine Needle Aspiration Cytology (FNAC). The tumour underwent en bloc marginal excision. The patients were followed up for minimum two year.
Our study population consisted of 18 females and 8 males. The mean age at the time of surgery was 38.3 years (range, 18-62 years). Twenty three cases were found in the 3rd and 4th decade. Twenty two cases involved upper extremity and only 4 cases in lower extremity. MRI was done in 2 cases where diagnosis was in doubt. Bony indentation on X-ray film was found in 7 cases and thorough curettage of cortical shell was done. All the cases were treated by marginal excision. Three cases developed post-operative stiffness but regained full range of movement with physiotherapy. Sensory impairment was seen in 3 cases. Recurrence occurred in 2 case and they were treated by repeat marginal excision.
Meticulous en-masse marginal excision of the giant cell tumour of tendon sheath in blood less field using magnification is the treatment of choice.
本研究的目的是强调腱鞘巨细胞瘤的发病率、良性性质以及彻底切除的必要性,从而将复发几率降至最低。
本研究纳入了2003年至2010年期间在巴特那医学院和医院骨科接受手术治疗的26例腱鞘巨细胞瘤病例。在对病变进行临床评估和细针穿刺细胞学检查(FNAC)后进行手术。肿瘤进行整块边缘切除。对患者进行了至少两年的随访。
我们的研究对象包括18名女性和8名男性。手术时的平均年龄为38.3岁(范围为18至62岁)。23例发生在第三和第四个十年。22例累及上肢,仅4例累及下肢。2例诊断存疑的病例进行了磁共振成像(MRI)检查。7例在X线片上发现骨质凹陷,并对皮质骨壳进行了彻底刮除。所有病例均采用边缘切除治疗。3例术后出现僵硬,但通过物理治疗恢复了全范围活动。3例出现感觉障碍。2例复发,再次进行边缘切除治疗。
在无血视野下使用放大镜对腱鞘巨细胞瘤进行细致的整块边缘切除是首选治疗方法。