Asaad Saywan K, Bapir Rawa, Salh Abdulwahid M, Abdullah Ari M, Tahir Soran H, Mikael Tomas M, Kakamad Fahmi H, Hassan Hunar A, Abdullah Hiwa O, Mohammed Shvan H
Smart Health Tower, François Mitterrand Street, Sulaimani, Kurdistan, Iraq.
Faculty of Medical Sciences, School of Medicine, University of Sulaimani, Sulaimani, Kurdistan, Iraq.
Ann Med Surg (Lond). 2021 Jul 26;69:102599. doi: 10.1016/j.amsu.2021.102599. eCollection 2021 Sep.
and importance: Giant cell tumors of the tendon sheath in children have rarely been reported in the literature. This study aims to present a case of giant cell tumors of the tendon sheath on the big toe of a 5-year-old child.
A 5-year-old girl presented with a painless swelling over the dorsal aspect of right big toe for 2 weeks. Physical examination revealed non-tender rubbery like swelling over the dorsal aspect of the right big toe. Ultrasound scan of the swelling showed a 17 × 7 mm oval-shaped subcutaneous hypoechoic lesion. Magnetic resonance imaging showed evidence of 20× 8 mm well-defined fusiform soft tissue lesion scalloping the bone. Under general anesthesia, the mass was totally excised. Microscopic sectioning showed a mixture of fibroblasts and histiocyte like cells associated with multinucleated giant cells in the vascular connective tissue stroma with the definite diagnosis of the giant cell tumor of the tendon sheath.
These tumors mostly compose of several types of cell like synovial, siderophages, foam, inflammatory and multinucleate giant cells. The major etiological factors that induce development of this tumor could be traumatic, inflammatory, metabolic or neoplastic disease.
although it is a sporadic finding, giant cell tumors of the tendon sheath might affect the lower limb in children. Complete excision is the main modality of treatment.
及重要性：儿童腱鞘巨细胞瘤在文献中鲜有报道。本研究旨在呈现一例5岁儿童大脚趾腱鞘巨细胞瘤的病例。
一名5岁女孩右大脚趾背侧出现无痛性肿胀2周。体格检查发现右大脚趾背侧有非压痛性橡皮样肿胀。对该肿胀进行超声扫描显示一个17×7毫米椭圆形皮下低回声病变。磁共振成像显示有一个20×8毫米边界清晰的梭形软组织病变，呈扇贝样侵蚀骨质。在全身麻醉下，将肿块完全切除。显微镜切片显示在血管结缔组织基质中有成纤维细胞和组织细胞样细胞的混合物，并伴有多核巨细胞，确诊为腱鞘巨细胞瘤。
这些肿瘤大多由几种类型的细胞组成，如滑膜细胞、含铁血黄素细胞、泡沫细胞、炎症细胞和多核巨细胞。诱发该肿瘤发生的主要病因可能是创伤、炎症、代谢或肿瘤性疾病。
尽管这是一个散发性病例，但腱鞘巨细胞瘤可能会影响儿童下肢。完整切除是主要的治疗方式。
