Keywords: Hand, Synovial neoplasm, Tenosynovial giant cell tumor, Tendon sheath, selleck inhibitor Tumor, Surgery Introduction Giant cell tumor of the tendon sheath (GCTTS) is the second most common tumor of the hand after ganglion cysts (1,2). It is a slowly growing, usually painless benign lesion of soft tissues. The tumor affects individuals between the age of 30 and 50 years old and is found more often in women than men (3�C6). Despite its benign character, local recurrence after excision has been reported in up to 45% of cases (7); there isn��t still a defined treatment protocol and local excision with or without radiotherapy is the treatment of choice to date (1,2,7�C13).
We made a retrospective study of literature of the last 15 years and evaluated the demographic, clinical and histological aspects of the GCTTS of the hand and compared the results with our experience in a series of 64 cases from 2000 to 2012 to assess the factors that mostly contribute to incidence and recurrence of this tumor. Patients and methods We searched for published articles regarding the GCTTS from 1998 using the PubMed search engine. The keywords used were as follows: ��giant cell tumor, tumor tendon, hand tumor��; all retrieved papers were analysed and their reference list were also screened if relevant. For each report, information was gathered on characteristics of the trial and study population, location and multicentricity of lesion, kind and severity of symptoms. We also recorded the applied treatment modality, histopathological examination of the excised tumor and recurrence rate.
A retrospective study was conducted in our Department of Plastic and Reconstructive Surgery and all data were collected from medical records of 64 GCTTS patients within this Department from 2000 to 2012. Medical record included the age, gender, tumor location, presentation and size, clinical features, treatment modality, histopathological report and neurovascular or tendon involvement. All cases were operated under tourniquet control, using a magnifying loupe. Special care was taken to excise the tumor in total, retaining the capsule, if present, with margin of normal tissue. The operating field is searched for presence of satellite lesions. The histopathological diagnosis and immunohistochemical studies were conducted by the Department of Pathology within the same Hospital. Follow-up ranged from 2�C153 months.
No patient within this study had been treated with chemotherapy or radiation prior to treatment at our institution, and no additional adjuvant treatments were performed. Results Cilengitide Age of patients ranged from 15 to 77 years (mean age 45 years) and GCTTS is found more often in the fourth and fifth decade of life. Out of 64 patients, 40 were females and 24 males, with a male to female ratio 1:1,66. The most frequent location of the tumor was the long finger in 23,5% (n=15).