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Joint Diseases and
Related Surgery
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Original Article · Open access

Clinical management of tenosynovial giant cell tumors

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Emin Kursat Bulut

Department of Orthopedics and Traumatology, Niğde Ömer Halisdemir University Faculty of Medicine, Niğde, Türkiye

ORCID: 0000-0002-0990-4116

Coskun Ulucakoy

Department of Orthopedics and Traumatology, Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye

ORCID: 0000-0002-6991-5511

Muzeyyen Burcu Kaplan

Department of Pathology, Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye

ORCID: 0000-0001-9574-7382

Ethem Toptas

Department of Orthopedics and Traumatology, Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye

ORCID: 0000-0003-3378-4094

Sefik Murat Arikan

Department of Orthopedics and Traumatology, Gazi University, Ankara, Türkiye

ORCID: 0000-0003-0376-5589

Mehmet Serkan Cetin

Department of Cardiology, Ankara Bilkent City Hospital, Ankara, Türkiye

ORCID: 0000-0002-3983-0496

Ismail Burak Atalay

Department of Orthopedics and Traumatology, Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye

ORCID: 0000-0002-6210-4193

Abstract

Objectives: This study aims to evaluate the demographic characteristics, anatomical distribution, diagnostic and treatment patterns, postoperative complications, recurrence rates, and recurrence-associated factors in patients diagnosed with tenosynovial giant cell tumors (TGCTs).

Patients and methods: A total of 246 patients diagnosed with TGCT and treated between January 2010 and March 2021, were retrospectively analyzed. Pre- and postoperative data of the patients were recorded. Histopathological diagnosis was reviewed, and tumors were classified as localized TGCT and diffuse-type TGCT. Recurrence was defined as the reappearance of a lesion at the same location following an initially complete surgical excision. Survival time was defined as the time elapsed since surgery. Recurrence-free survival was calculated from the date of the surgical procedure to the date of recurrence or the last follow-up.

Results: Of a total of 246 patients included in the study, 87 were male and 159 were female with a mean age of 44.3 ± 16.3 (range, 18 to 75) years. The lesions were most commonly located in the hand (62.6%), predominantly at the phalangeal level (89.6%). Foot involvement was mainly at the ankle region (40.8%), while the knee was the third most frequently affected site (15%), with 64.8% of knee lesions being intra-articular. Multiple lesions were observed in 3.3% of patients. Small joints were involved in 63% of cases. Excisional biopsy was the most common diagnostic approach (63.8%), followed by Tru-Cut biopsy (23.2%) and incisional biopsy (8.5%), while macroscopically complete marginal resection was performed in 4.5% of cases. Postoperative complications occurred in 15.4% of patients, including infection, sensory deficits, hematoma, motion restriction, and vascular complications. The median follow-up was 43 months, and recurrence occurred in 15.4% of patients, of whom 76.3% required reoperation.

Conclusion: Our study results suggest that TGCT is associated with a notable recurrence rate and postoperative morbidity. Accurate diagnosis, complete surgical excision, and long-term follow-up are essential for optimal management. Recurrence may be associated with factors such as pain at presentation, presence of multiple lesions, delayed treatment, and postoperative infection. Adequate surgical excision with sufficient margins is of utmost importance in reducing the risk of recurrence.

Declarations

Author Contributions

E.K.B.: Contributed to conceptualization, investigation, project administration, and writing-original draft; C.U., S.M.A., I.B.A.: Contributed to methodology; E.T., M.B.K.: Contributed to investigation; M.S.C.: Contributed to formal analysis and writing. All authors reviewed and approved the final version of the manuscript.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

AI Disclosure

The authors declare that artificial intelligence (AI) tools were not used, or were used solely for language editing, and had no role in data analysis, interpretation, or the formulation of conclusions. All scientific content, data interpretation, and conclusions are the sole responsibility of the authors. The authors further confirm that AI tools were not used to generate, fabricate, or ‘hallucinate’ references, and that all references have been carefully verified for accuracy.

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