Symeonidis Panagiotis D, Tsatlidou Maria, Spanos Ioannis, Papageorgiou Maria, Kesisis Georgios, Zarampouka Katerina
Department of Orthopaedic, St Luke's Hospital, Panorama, Thessaloniki, Greece, Thessaloniki, Greece.
Bioiatriki S.A., Diagnostic Center, Thessaloniki, Greece.
J Orthop Case Rep. 2023 Jun;13(6):89-93. doi: 10.13107/jocr.2023.v13.i06.3708.
The term tenosynovial giant cell tumor encompasses a group of rare soft-tissue tumors. A new classification divides the group in localized and diffuse type, depending on the involvement of the surrounding tissues. Due to the unclear origin and heterogeneity in extend of the diffuse-type giant cell tumors, there is only limited evidence on the tumor-specific treatment. Thus, every case report has an added value toward setting disease-specific guidelines.
Presentation of a diffuse type tenosynovial giant cell tumor encircling the first metatarsal. The tumor had mechanically eroded the plantar aspect of the distal metaphysis, with no signs of tumor spread. After an open biopsy, resection of the mass was performed without debriding or resecting the first metatarsal. Repeat imaging postoperatively showed no recurrence at 4-year follow-up and a bony remodeling of the lesion.
Bone remodeling is possible after complete resection of diffuse tenosynovial giant cell tumor when the erosion is caused by mechanical pressure and no intraosseous expansion of the tumor is present.
腱鞘巨细胞瘤这一术语涵盖了一组罕见的软组织肿瘤。一种新的分类方法根据周围组织的受累情况将该组肿瘤分为局限性和弥漫性类型。由于弥漫型巨细胞瘤的起源不明且范围存在异质性,关于肿瘤特异性治疗的证据有限。因此,每例病例报告对于制定疾病特异性指南都具有附加价值。
呈现一例环绕第一跖骨的弥漫型腱鞘巨细胞瘤。肿瘤机械性侵蚀了远端干骺端的足底侧,无肿瘤扩散迹象。开放活检后,在未清创或切除第一跖骨的情况下对肿块进行了切除。术后重复影像学检查显示,在4年随访时无复发,且病变出现骨重塑。
当弥漫性腱鞘巨细胞瘤的侵蚀是由机械压力引起且肿瘤无骨内扩展时,完全切除后骨重塑是可能的。