Giotis Dimitrios, Konstantinidis Christos, Plakoutsis Sotiris, Kotsias Christos, Galanis Charilaos, Konstantinou Alkisti, Anagnostou Evangelos, Tsiampas Dimitrios, Vardakas Dimitrios, Panagiotopoulos Vasileios
Orthopaedic Department, General Hospital of Ioannina "G. Hatzikosta", Ioannina,Greece.
Maedica (Bucur). 2024 Dec;19(4):856-860. doi: 10.26574/maedica.2024.19.4.856.
The aim of this study is to present a case of giant cell tumor of the tendon sheath in the anatomical snuffbox, an extremely unusual location of such neoplasms. A 54-year-old male came to our hospital with a mass in his left hand that had appeared over the past two years, demonstrating a recent rapid increase in size. The physical examination revealed that the mass did not cause any pain or restriction in the range of motion. The neurovascular function remained intact. The magnetic resonance imaging (MRI) detected a 2.5 x 1.5 cm mass in the anatomical snuffbox but without a clear diagnosis. A meticulous marginal surgical excision was performed and biopsy sample was sent for histopathologic examination. Intraoperatively, it was observed that the tumor extended in-between the tendons of the first and third dorsal compartments, reaching the radial artery at the depth of the anatomical snuffbox. Macroscopically, the tumor resembled a giant cell tumor, which was confirmed by histological examination. The patient was discharged from the hospital on the same day. He fully resumed his daily activities three weeks after surgery. Three years later, he remained free of symptoms without any recurrence of the tumor. Giant cell tumor of the tendon sheath is a benign neoplasm that demonstrates local aggressiveness. In several cases, nerves and blood vessels might be entrapped within the tumor. This complication along with its high recurrence rate renders surgical excision of the tumor a particularly demanding procedure.
本研究的目的是报告一例发生于解剖学鼻烟壶区的腱鞘巨细胞瘤，该肿瘤的这一部位极为罕见。一名54岁男性因左手肿物前来我院就诊，该肿物已出现两年，近期体积迅速增大。体格检查发现该肿物未引起任何疼痛或活动受限。神经血管功能保持完好。磁共振成像（MRI）在解剖学鼻烟壶区检测到一个2.5×1.5 cm的肿物，但未明确诊断。遂进行了细致的边缘性手术切除，并将活检样本送去做组织病理学检查。术中观察到肿瘤在第一和第三背侧间室的肌腱之间延伸，在解剖学鼻烟壶区深处累及桡动脉。大体上，肿瘤类似腱鞘巨细胞瘤，组织学检查证实了这一点。患者于同日出院。术后三周他完全恢复了日常活动。三年后，他仍无症状，肿瘤未复发。腱鞘巨细胞瘤是一种具有局部侵袭性的良性肿瘤。在一些病例中，神经和血管可能会被肿瘤包绕。这种并发症及其高复发率使得肿瘤的手术切除成为一项特别具有挑战性的操作。
