Giant Cell Tumor of Tendon Sheath




Tenosynovial Pigmented Villonodular Synovitis (PVNS), Nodular PVNS


CLINICAL SUMMARY


Giant cell tumor of tendon sheath is a slow-growing tumor associated with mechanical pain, most commonly in the hands and feet. On imaging, it typically appears as a nodular mass in close proximity to a tendon sheath. Marginal excision is adequate and associated with a low risk of recurrence.


DIAGNOSTIC FEATURES


















History


  • Most common between 30 and 50 years of age



  • Slow-growing, small nodular mass



  • Pain with direct pressure or movement of the digit

Location


  • Occurs along the tendon sheath



  • Most common in the hands and feet

MRI


  • Low signal on T1; variable low signal on T2



  • Adjacent to a tendon or joint capsule




IMAGING
























  • Radiographs of a giant cell tumor of the tendon sheath in the hand show a subtle soft tissue mass density volar to the middle phalanx with no mineralization or bone erosion ( left ).



  • Extrinsic bone erosion ( right ) is seen in up to 15% of patients.


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