Arican Mehmet, Turhan Yalçın
J Am Podiatr Med Assoc. 2020 May 1;110(3). doi: 10.7547/19-038.
Giant cell tumor of the tendon sheath (GCTTS) in the foot is a rare pathology and is involved in the differential diagnosis of soft-tissue tumors of the foot and ankle. Although it can affect any age group, GCTTS mainly occurs at the 3rd and 5th decade and is more common in females. Histopathologic examination is a major definitive method for diagnosis, although physical examination and radiologic imaging are helpful in reaching a diagnosis preoperatively. Many treatment options exist but marginal excision is the most commonly used treatment. We describe the case of a 26-year-old pregnant woman with a multi-fragmented mass extending from the first web space to the plantar aspect of the metatarsophalangeal joint (MTP) of the left great toe associated with flexor hallucis longus tendon after trauma. She had pain that worsened with activity and wearing shoes. After pregnancy, a marginal excision with dorsal longitudinal incision in the first web space was performed under spinal anesthesia. The lesion was diagnosed as a localized type tenosynovial giant cell tumor. At the last follow-up appointment in the 23rd month, the patient was doing well and there was no recurrence of the lesion. GCSST should be considered in the differential diagnosis of plantar masses of foot. Although, GCTTS is frequently seen in females, it has not been previously reported in a pregnant woman with an extremely rare condition after trauma.
足部腱鞘巨细胞瘤(GCTTS)是一种罕见的病理情况,参与足踝部软组织肿瘤的鉴别诊断。尽管它可发生于任何年龄组,但GCTTS主要发生在30至50岁之间,且在女性中更为常见。组织病理学检查是诊断的主要决定性方法,尽管体格检查和影像学检查有助于术前做出诊断。存在多种治疗选择,但边缘切除是最常用的治疗方法。我们描述了一名26岁孕妇的病例,她在受伤后出现一个多碎片肿块,从第一趾蹼间隙延伸至左拇趾跖趾关节(MTP)的足底侧,并与拇长屈肌腱相关。她活动及穿鞋时疼痛加剧。产后,在脊髓麻醉下于第一趾蹼间隙行背侧纵向切口边缘切除。病变被诊断为局限性腱鞘巨细胞瘤。在第23个月的最后一次随访时,患者情况良好,病变无复发。在足部足底肿块的鉴别诊断中应考虑GCSST。尽管GCTTS在女性中常见,但此前尚未有创伤后极为罕见情况下孕妇患GCTTS的报道。