Skip to content

Patients › Hand

Giant Cell Tumor ng Tendon Sheath (Buto sa Daliri o Hinlalaki)

PDF Evidence

A giant cell tumour of tendon sheath is a common, benign (non-cancerous) lump on a finger or thumb. What causes it, how it is diagnosed and removed, and how often it comes back.

Updated Aug 2026
Isang guhit-kamay na ilustrasyon ng isang benign na malambot na bulto sa gilid ng daliri.
Sa ilalim ng mikroskopyo, ang giant cell tumour ng tendon sheath ay binubuo ng mga cluster ng multinucleated giant cells (ang mga madilim, magaspang na itsura na mga cell) na halo-halo sa mas maliliit na mononuclear cells. Ito ay benign, at ang itsura ng mga giant cell ang nagbigay ng pangalan sa lesion. Kieran Hirpara 4.0

Ang pahinang ito ay isinalin ng makina at hindi pa nasusuri ng isang doktor. Ang bersyong Ingles ang siyang opisyal.

Ano ang nararamdaman mo

Maaaring mapansin mo ang isang maliit, matigas na buntong sa iyong daliri o hinlalaki. Ito ay isang benignong paglago, na nangangahulugan na hindi ito kanser. Nakaupo ito sa tendon sheath, ang madulas na takip na tumutulong sa iyong mga tendon na gumalaw nang maayos. Karamihan sa mga tao ay nakakakita na ang buntong ito ay walang sakit sa simula. Maaaring pakiramdam lang nito ay isang kakaibang buntong sa ilalim ng balat.

Habang lumalaki ang buntong, maaari itong pindutin ang mga malalapit na nerbiyos o tisyu. Maaaring makaramdam ka ng mapait na sakit o matulis na sakit sa partikular na lugar na iyon. Karaniwang lumalala ang sakit kapag gumagamit ng iyong kamay. Ang mga gawain na nangangailangan ng hawak o pagpipit, tulad ng pagbubukas ng bote o paghawak ng telepono, ay maaaring maging hindi komportable. Maaari ring mapansin mo ang pagkakasikip ng kasukasuan sa kasukasuan malapit sa buntong.

May ilang tao ang nakakakita ng sakit sa gabi. Maaari itong magpahina sa pagtulog o pagmanat sa pagtulog. Ang paghiga sa kamay na iyon ay maaaring magdagdag ng presyon sa buntong, na nagdudulot ng pulso o tingling. Maaari kang gumising na may mahigpit na daliri na tumatagal ng ilang minuto bago lumuwag.

Ang mga araw-araw na gawain ay maaaring maging mahirap. Ang mga simpleng galaw tulad ng pag-button ng damit o pagtatakip ng iyong itaas na bahagi ay maaaring maging kakaiba. Ang pag-abot sa likod ng iyong likod upang i-fasten ang bra o ayusin ang iyong damit ay maaaring maging masakit. Maaari kang makakita na iwasan ang paggamit ng kamay na iyon para sa mabigat na pag-angat o paulit-ulit na mga gawain.

Mahalagang malaman na maaaring bumalik ang buntong pagkatapos ng pag-alis. Ang lokal na pagbabalik ay nakikita sa hanggang 20% ng mga kaso. Karamihan sa mga pagbabalik ay nangyayari sa loob ng unang dalawang taon pagkatapos ng operasyon. Gayunpaman, may ilang pasyente na nananatiling nasa panganib sa loob ng mas matagal, na may mga pagbabalik na nangyayari sa labindalawa hanggang tatlumpung taon pagkatapos ng paunang paggamot. Ito ang dahilan kung bakit susubaybayan ng iyong doktor ang lugar nang mahigpit sa loob ng panahon.

Kung mayroon kang namaga sa loob ng mahabang panahon, o kung nagsimula ang pamamaga pagkatapos ng isang pinsala, kinakailangan ang tamang pag-imaging. Tinitiyak nito ang pagwawakas ng ibang kondisyon. Bagama't bihira, ang mga tumor ng malambot na tisyu ay maaaring magmukhang karaniwang pinsala. Ang pagiging mabuti ay susi upang matiyak na makakuha ka ng tamang diagnosis at paggamot. Ang iyong doktor ay gabayin ka sa mga susunod na hakbang upang pamahalaan ang iyong mga sintomas at maiwasan ang mga komplikasyon.

Ano ang nangyayari talaga

Ang giant cell tumour of the tendon sheath ay isang karaniwang, hindi kanserosong buto na bumubuo sa iyong kamay. Karaniwan itong lumalabas sa isdaliri o hinlalaki. Maaaring matakot ang pangalan, ngunit ang paglago na ito ay benign. Ibig sabihin nito, hindi ito kumakalat sa ibang bahagi ng iyong katawan.

Ang buto ay bumubuo sa malambot na tissue na sumasakop sa iyong mga tendon. Ang mga tendon ay matibay, hibla na parang lubid na nag-uugnay sa iyong mga kalamnan sa iyong mga buto. Pinapayagan nito kang yumuko at tuwid ang iyong mga daliri. Ang tumour ay dahan-dahang lumalago sa loob ng tendon sheath, na ang protektibong manggas na nakapalibot sa mga hiblang ito.

Habang lumalaki ang masa, ito ay tumutulak sa mga kalapit na istraktura. Ang presyur na ito ang nagdudulot ng mga sintomas na maaaring mararamdaman mo. Maaaring mapansin mo ang matigas, walang sakit na butil sa ilalim ng balat. Sa ilang kaso, ang paglago ay maaaring mag-irita sa joint o limitahan ang galaw.

Kahit na ang mga tumour na ito ay benign, maaari silang maging agresibo sa bihirang mga kaso. Mayroon silang kagustuhang bumalik pagkatapos ng pag-alis. Ito ang dahilan kung bakit mahalaga ang maingat na paggamot. Ang iyong surgeon ay layuning alisin ang buong buto upang bawasan ang risk na bumalik ito.

Mahalagang paghiwalayin ang kondisyong ito sa ibang mga buto sa kamay. Minsan, ang mga imaging tests tulad ng X-rays o MRIs ay hindi malinaw na makakapaghihiwalay sa pagitan ng giant cell tumour at iba pang uri ng mga paglago. Ito ang dahilan kung bakit mahalaga ang tumpak na diagnosis bago desisyunin ang paggamot.

Habang ang mga tumour na ito ay pinakakaraniwan sa mga matatanda, bihirang ito sa mga bata. Kung mayroon kang buto sa iyong kamay, ang iyong surgeon ay masusing e-evaluate ito. Itutukoy nila kung ang partikular na uri ng paglago na ito ay naroroon at magplaplano ng pinakamainam na paraan para sa iyo.

Mga ginagawa namin para rito

Sa Mater Private Hospital Rockhampton, pinapamamaraan ni Dr. Kieran Hirpara ang kondisyong ito sa pamamagitan ng pagkumpirma muna kung ano eksakto ang bulto. Tumutulong ang imaging upang matukoy namin kung ang giant cell tumour of the tendon sheath ba ito kumpara sa ibang sanhi, bagama’t minsan ay maaari itong magmukhang katulad ng iba pang isyu sa malambot na tisyu. Sinisimulan namin ang malinaw na diagnosis bago pumili ng landas.

Para sa maraming pasyente, nagsisimula kami sa konservatibong paggamot. Kasama rito ang pagbabago sa aktibidad upang bawasan ang stress sa daliri o hinlalaki, at hand therapy upang panatilihing makinis ang galaw ng kasukasuan. Kung mayroong sakit o pamamaga, maaari naming inirerekomenda ang mga anti-inflammatory na gamot o isang cortisone injection upang paitiin ang lugar. Layunin ng mga hakbang na ito na pamahalaan ang mga sintomas at mapabuti ang pagganap nang walang operasyon. Karaniwan naming binibigyan ng patas na pagsubok ang paraang ito upang makita kung nagbibigay ito ng sapat na ginhawa.

Isinasalang-aling ang operasyon kapag hindi nagbibigay ng sapat na pagpapabuti ang konservatibong paggamot, o kung lumalaki ang bulto o nakakaapekto ito sa pagganap ng iyong kamay. Ang mga giant cell tumour of the tendon sheath ay benign (hindi kanseroso) ngunit maaaring mag-recur (bumalik) pagkatapos ng pag-alis. Ang aming layunin ay ang masusing ngunit konservatibong pag-alis upang matanggal ang bulto habang pinapanatili ang pagganap ng iyong kasukasuan at tendon. Sa ilang kaso, kung ang lesion ay nakakaapekto sa buto, maaari naming gamitin ang isang teknika na tinatawag na curettage, kung saan aming kakaliskisin ang apektadong lugar, minsan ay punan ang espasyo ng bone cement upang suportahan ang istruktura.

Ang recurrence ay isang kilalang panganib. Karamihan sa mga recurrence ay nangyayari sa loob ng unang dalawang taon, ngunit ang ilang mga pasyente ay nananatiling nasa panganib sa loob ng mas matagal, na may mga recurrence na nangyayari hanggang sa tatlongampung taon pagkatapos ng paunang paggamot. Mahigpit naming pinagmamasdan ka pagkatapos ng operasyon upang maagang makita ang anumang pagbabago. Kung mangyari ang recurrence, epektibo pa rin ang karagdagang operasyon. Hindi tila binabawasan ang epektibidad ng paggamot sa recurrence gamit ang simpleng pagkakaliskis o mas malawak na pag-alis ng mga naunang paggamot tulad ng paglalagay ng cement.

Sa bihirang mga kaso kung saan ang tumour ay malawak o mahirang alisin sa pamamagitan ng operasyon, maaaring maging opsyon ang radiation therapy. Ipinaliliwanag ng mga pag-aaral na ang radiation ay epektibong nakokontrol ang tumour, na may walong-pu’t limang porsyentong rate ng kawalan ng pag-unlad sa loob ng sampung taon. Ito ay isang ligtas at epektibong alternatibo kapag hindi feasible ang operasyon.

Tinitingnan namin ang paggamot bilang isang shared decision. Usapin namin sa iyo ang mga panganib, benepisyo, at posibilidad ng recurrence. Ang aming layunin ay kontrolin ang lesion sa lokal na antas habang pinapanatili ang pagganap ng iyong kamay sa pangmatagalan. Sa pamamagitan ng therapy, gamot, o operasyon, iniaangkop namin ang plano sa iyong partikular na pangangailangan at sakop ng sakit.

Ano ang inaasahan

Ang giant cell tumour of tendon sheath ay isang karaniwang, hindi kanserosong buntong sa iyong daliri o hinlalaki. Kahit benign ito, maaari itong muling lumitaw pagkatapos ng pag-alis. Karamihan sa mga pagkabalik ay nangyayari sa loob ng unang dalawang taon. Gayunpaman, may ilang pasyente na nananatiling nasa panganib sa loob ng mas matagal, na may mga pagkabalik na nangyayari labindalawa hanggang tatlongampung taon pagkatapos ng paunang paggamot.

Kung iiwanan mo ang buntong, maaari itong manatili o dahan-dahang lumaki. Bihirang maglaan sa sarili nito. Dahil maaaring lokal na agresibo ang mga tumour na ito, malamang na irekomenda ng iyong doktor ang pag-alis upang pigilan ang karagdagang paglago at protektahan ang pag-andar ng iyong kasukasuan.

Pagkatapos ng operasyon, kailangan ng iyong kamay ng oras upang gumaling. Inaasahan ang ilang pamamaga at katigasan habang binabawi ang galaw. Karamihan sa mga tao ay bumabalik sa karaniwang mga gawain sa loob ng ilang linggo, bagaman maaaring tumagal ng mas matagal ang buong lakas. Sinusubaybayan namin nang mahigpit ang iyong progreso upang matiyak na nananatiling matatag at functional ang kasukasuan.

Sa bihirang mga kaso, maaaring maiwan ang mga selula ng tumour sa surgical scar, na nagdudulot ng pagkabalik sa malambot na tisyu. Ito ang dahilan kung bakit binibigyan namin ng masusing pansin ang detalye ng operasyon. Kung muling lumitaw ang tumour, madalas itong maipagagamot muli gamit ang maingat na pagkaskas o mas malawak na pag-alis. Epektibo ang mga ulit na prosedura na ito at hindi binabawasan ang iyong pagkakataon para sa pangmatagalang kontrol.

Para sa karamihan sa mga pasyente, ang outlook ay positibo. Inaasahan na mapanatili ang buong paggamit ng iyong kamay. Layunin namin ang matibay, kasukasuan-pang-iing na pag-andar. Kahit mahalaga ang pagbabantay, hindi mo kailangang mag-alala nang sobra. Ang regular na mga check-up ay tumutulong sa amin na makakita ng anumang pagbabago nang maaga. Sa tamang pag-aalaga, maaari mong mapanatiling malusog at aktibo ang iyong kamay sa mga susunod na taon.

Kailan makipag-ugnayan sa doktor

Kumonsulta sa iyong doktor kung napansin mo ang isang patuloy na buntis sa iyong daliri o hinlalaki na hindi nawawala. Humingi ng pagsusuri ng espesyalista kung mayroon kang sakit na hindi gumagaling sa pamamagitan ng pahinga, o kung ang buntis ay nagdudulot ng kahinaan, pagkakasara, o kawalan ng katatagan sa iyong kamay. Humingi ng agad na pag-aalaga kung biglaang lumala ang mga sintomas o nakakaapekto sa iyong pagtulog o trabaho. Ang matagal na pamamaga, kahit pagkatapos ng isang pinsala, ay maaaring magpahiwatig ng seryosong kondisyon na nangangailangan ng tamang pag-imaging bago ang operasyon. Ang maagang pagsusuri ay tumutulong upang maiwasan ang mga komplikasyon at tinitiyak ang pinakamahusay na resulta para sa iyong pag-andar ng kamay.

Reviewed by Kieran Hirpara · 28 April 2026.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Giant cell tumors of the tendon sheaths in the hand are benign lesions [2, 3].
  • Recurrence is the primary risk associated with giant cell tumors of the tendon sheaths in the hand [2, 3].
  • Recurrence of giant cell tumors of the tendon sheaths in the hand typically occurs within 36 months of excision [2].
  • Complete surgical resection remains the treatment of choice for most patients with tenosynovial giant cell tumors [6].
  • Diffuse disease in tenosynovial giant cell tumors presents challenges due to high recurrence rates [6].
  • In cases of infiltrative giant cell tumor of the tendon sheath, radiation therapy may provide local tumor control with preservation of hand function [1].
  • Total surgical excision ensuring removal of the attachment site (flexor sheath/palmar fascia) resulted in no local recurrences at a mean follow-up of 3.2 years for fibroma of the tendon sheath [7].
  • Well-designed studies combining the recurrence rates of several hand surgery centers implementing a standardized treatment are needed to better demonstrate the associated risk factors for recurrence of giant cell tumor of the tendon sheath in the hand [8].

Anatomy & Pathophysiology

  • Radiation therapy may provide local tumor control with preservation of hand function in cases of infiltrative Giant Cell Tumor of the Tendon Sheath (GCTTS) [1].
  • Surgical treatment for Pigmented Villonodular Synovitis (PVNS) led to good functional results with an average Enneking score of 92% of normal limb function [10].
  • Patients with diffuse Pigmented Villonodular Synovitis reported good functional outcomes without evidence of recurrence in a 19-patient cohort with an average follow-up of almost 7 years [22].
  • Satisfactory functional results in diffuse Pigmented Villonodular Synovitis mirror the status of the underlying joint [42].

Classification

  • Giant cell tumors of the synovial sheaths in the hand are benign lesions [3].
  • Tenosynovial giant cell tumors include pigmented villonovular synovitis [6].
  • Fibroma of the tendon sheath is a distinct entity from giant cell tumor of the tendon sheath [7].
  • Epiphyseal chondromatous giant cell tumors represent a distinct clinical entity of essentially benign giant cell tumors [9].
  • Giant cell tumors of bone in the hand are a rare condition [4].
  • Giant cell tumors of the distal radius are classified into Grades 1, 2, and 3 [14].
  • Tumors with extension limited to a single site of palmar cortical perforation are classified as grade 3(p) [35].
  • Campanacci grade III giant cell tumours of the distal radius are a specific classification subset [40].
  • Direct involvement of the extensor tendons, flexor tendons, or joint capsule places patients in a high-risk category with respect to recurrence [25].
  • Grade III lesions, particularly with extensive soft tissue involvement, represent a subset of patients at higher risk of recurrence [18, 12].

Clinical Presentation

  • Giant cell tumors of the tendon sheaths in the hand are benign synovial neoplasms [21].
  • Giant cell tumors of the tendon sheaths in the hand have the potential for local recurrence [21].
  • Recurrence is the primary risk for giant cell tumors of the tendon sheaths in the hand [2, 3].
  • Direct involvement of the extensor tendons, flexor tendons, or joint capsule puts patients in a high-risk category with respect to recurrence [25].

Investigations

  • Radiation therapy may provide local tumor control with preservation of hand function in cases of infiltrative giant cell tumor of the tendon sheath [1].
  • Giant cell tumors of the tendon sheaths in the hand are benign lesions where recurrence is the primary risk, typically occurring within 36 months of excision [2].
  • Giant cell tumors of the synovial sheaths in the hand are benign lesions in which recurrence is the primary risk [3].
  • Complete surgical resection remains the treatment of choice for most patients with tenosynovial giant cell tumors, though diffuse disease presents challenges due to high recurrence rates [6].
  • Total surgical excision ensuring removal of the attachment site (flexor sheath/palmar fascia) resulted in no local recurrences at a mean follow-up of 3.2 years for fibroma of tendon sheath of the hand [7].
  • Pigmented villonoid synovitis and giant-cell tumor of tendon sheath are benign synovial neoplasms with the potential for local recurrence [21].
  • Although MRI findings and location might help in the diagnosis of a tenosynovial giant cell tumor, careful assessment is mandatory, especially in unusual locations [33].
  • Pigmented villonodular synovitis of the shoulder is extremely rare, with clinical and radiological findings generally being nonspecific and often mimicking a malignancy [38].

Treatment

  • Both curettage and resection/amputation are acceptable treatment options for giant cell tumour of bone in the hand, with treatment decisions needing to be individualized based on the site and extent of disease to minimize morbidity while maximizing disease control [4].
  • Intralesional excision remains a viable, and likely the standard, mode of treatment for most giant cell tumors of the distal radius unless there is extensive bone loss [5].
  • Well-designed studies combining the recurrence rates of several hand surgery centers implementing a standardized treatment are needed to better demonstrate the associated risk factors for recurrence in giant cell tumor of tendon sheath in the hand [8].
  • Conservative treatments yielded good results without amputation for epiphyseal chondromatous giant cell tumors of the upper end of the humerus [9].
  • Centralization of the ulna is a simple and effective modality of reconstruction following resection of Campanacci Grade 3 giant cell tumor of the distal radius [11].
  • En bloc resection and matched nonvascularized toe phalangeal transfer for Campanacci Grade 2 or 3 giant cell tumor of the phalanges resulted in a functional tumor-free digit with a low complication rate and no recurrences [13].
  • Intralesional excision appears to be more appropriate for the treatment of local lesions (Grades 1 and 2) than Grade 3 giant cell tumors of the distal radius [14].
  • The use of a massive biocompatible bipolar unconstrained prosthesis is a viable treatment option for distal radius reconstruction after en-bloc resection of a giant cell tumour, offering rapid functional improvement without donor-site morbidity [17].
  • Selective use of curettage and cementing is recommended in Grade III giant cell tumor lesions, particularly with extensive soft tissue involvement [18].
  • Intralesional excision with cautery and methylmethacrylate provides a reliable method of treatment of giant cell tumors with good long-term functional results [19].
  • Intralesional excision with local adjuvant therapy is recommended for the treatment of giant cell tumor of bone because it results in a good functional outcome compared to extralesional excision [27].
  • Repeated curettage with adjuvants eventually resulted in the cure for all patients and is therefore a reasonable treatment for both primary and recurrent giant cell tumor of the small bones of the hands and feet [28].
  • Reconstruction after wide excision by nonvascularized fibular graft is a viable alternative for giant cell tumors of the lower end of radius, though it is a challenging procedure that may be accompanied by major complications [29].
  • Non-surgical treatment has a similar risk of complications to intralesional nerve-sparing surgery and has better functional outcomes than intralesional nerve-sparing surgery for giant cell tumor of the sacrum, but patients must remain on therapy over time [32].

Complications

  • Well-designed studies combining recurrence rates from several hand surgery centers are needed to better demonstrate associated risk factors for recurrence [8].
  • Subsets of patients with giant cell tumor of bone are at higher risk of recurrence and should be clinically followed more closely [12].
  • Metachronous multicentric giant cell tumor can present with long disease-free intervals, such as 24 years between initial presentation and multicentric recurrence [15].

Recovery

  • Recurrence is the primary risk for giant cell tumors of the tendon sheaths in the hand, typically occurring within 36 months of excision [2].
  • Recurrence is the primary risk for giant cell tumors of the synovial sheaths in the hand [3].
  • Surgical treatment of pigmented villonous synovitis led to good functional results with an average Enneking score of 92% of normal limb function [10].
  • A patient with metachronous multicentric giant cell tumor had a disease-free interval of 24 years between the initial presentation and the multicentric recurrence [15].
  • The distal ulna may be widely resected with or without stabilization of the residual ulnar stump, yielding satisfactory local disease control and functional outcome [20].
  • Patients with pigmented villonous synovitis of the hip managed with arthroscopic synovectomy reported good functional outcomes without evidence of recurrence in a cohort with an average follow-up of almost 7 years [22].
  • Tumor resection with negative margins is supported for giant cell tumors in the radius [26].

Key Evidence

  • [L4] In cases of infiltrative GCTTS, radiation therapy may provide local tumor control with preservation of hand function. [1] (10.1016/j.jhsa.2012.01.011)
  • [L4] Giant cell tumors of the tendon sheaths in the hand are benign lesions where recurrence is the primary risk, typically occurring within 36 months of excision. [2] (10.1016/j.otsr.2013.03.008)
  • [L4] Giant cell tumors of the synovial sheaths in the hand are benign lesions in which recurrence is the primary risk. [3] (10.1016/j.jhsa.2013.08.051)
  • [L4] Both curettage and resection/amputation are acceptable treatment options for the rare condition of giant cell tumour of bone in the hand, with a need to individualize treatment decisions based on the site and extent of disease to minimize treatment morbidity while maximizing disease control. [4] (10.1177/17531934211007820)
  • [L3] Intralesional excision remains a viable, and likely the standard, mode of treatment for most giant cell tumors of the distal radius unless there is extensive bone loss. [5] (10.1007/s11999-014-4054-3)
  • [L5] Complete surgical resection remains the treatment of choice for most patients with tenosynovial giant cell tumors, though diffuse disease presents challenges due to high recurrence rates. [6] (10.5435/jaaos-d-24-01255)
  • [L4] Total surgical excision ensuring removal of the attachment site (flexor sheath/palmar fascia) resulted in no local recurrences at a mean follow-up of 3.2 years. [7] (10.1177/1753193412469146)
  • [L3] Well-designed studies combining the recurrence rates of several hand surgery centers implementing a standardized treatment are needed to better demonstrate the associated risk factors for recurrence. [8] (10.1186/s12891-019-2866-8)
  • [L4] The author concludes that these tumors represent a distinct clinical entity of essentially benign giant cell tumors that should be recognized in the literature, noting that conservative treatments yielded good results without amputation. [9] (10.1097/01.blo.0000229309.90265.df)
  • [L4] Surgical treatment led to good functional results with an average Enneking score of 92% of normal limb function. [10] (10.1097/01.blo.0000224051.01873.fb)
  • [L4] This is a simple and effective modality of reconstruction after resection of distal radial tumors. [11] (10.1016/j.jhsa.2022.05.011)
  • [L4] Our observations suggest there are subsets of patients with giant cell tumor of bone who are at higher risk of recurrence and should be clinically followed more closely. [12] (10.1007/s11999-011-2172-8)
  • [L4] En bloc resection and matched nonvascularized toe phalangeal transfer resulted in a functional tumor-free digit with a low complication rate and no recurrences. [13] (10.1016/j.jhsa.2024.06.013)
  • [L3] Based on data obtained from the number of studies available, intralesional excision appears to be more appropriate for the treatment of local lesions (eg, Grades 1 and 2) than Grade 3 GCTs of the distal radius. [14] (10.1007/s11999-012-2464-7)
  • [L4] This patient has the longest disease-free interval of a metachronous multicentric giant cell tumor reported to date, with 24 years passing between the initial presentation and the multicentric recurrence. [15] (10.1097/01.blo.0000068770.86536.e1)
  • [Case_report] The use of a massive biocompatible bipolar unconstrained prosthesis is a viable treatment option for distal radius reconstruction after en-bloc resection of a giant cell tumour, offering rapid functional improvement without donor-site morbidity. [17] (10.1016/j.otsr.2013.04.001)
  • [L4] We recommend selective use of this procedure in Grade III lesions, particularly with extensive soft tissue involvement. [18] (10.4103/0019-5413.77138)
  • [L4] Intralesional excision with cautery and methylmethacrylate provides a reliable method of treatment of giant cell tumors with good long-term functional results. [19] (10.1097/01.blo.0000128280.59965.e3)
  • [L3] The distal ulna may be widely resected with or without stabilization of the residual ulnar stump, yielding satisfactory local disease control and functional outcome. [20] (10.1177/1558944717743598)
  • [L4] Pigmented villonoid synovitis and giant-cell tumor of tendon sheath are benign synovial neoplasms with the potential for local recurrence. [21] (10.2106/00004623-198466010-00012)
  • [L4] Patients reported good functional outcomes without evidence of recurrence in a 19 patient cohort with an average follow-up of almost 7 years. [22] (10.1177/2325967119s00413)
  • [L3] Direct involvement of the extensor tendons, flexor tendons, or joint capsule puts patients in a high-risk category with respect to recurrence. [25] (10.1016/j.jhsa.2009.12.004)
  • [L4] Findings support tumor resection with negative margins in the radius. [26] (10.1016/j.jhsa.2017.06.079)
  • [L3] Intralesional excision with local adjuvant therapy is recommended for the treatment of giant cell tumor of bone because it results in a good functional outcome compared to extralesional excision. [27] (10.1007/s004020100317)
  • [L3] Repeated curettage with adjuvants eventually resulted in the cure for all patients and is therefore a reasonable treatment for both primary and recurrent GCT of the small bones of the hands and feet. [28] (10.1302/0301-620x.95b6.30876)
  • [L4] Reconstruction after wide excision by nonvascularized fibular graft is a viable alternative for giant cell tumors of the lower end of radius though it is a challenging procedure and may be accompanied by major complications. [29] (10.1007/s00402-010-1059-6)
  • [L3] Non-surgical treatment has a similar risk of complications to intralesional nerve-sparing surgery and has better functional outcomes than intralesional nerve-sparing surgery, but patients must remain on therapy over time. [32] (10.1186/s12891-021-04907-0)
  • [L4] Although MRI findings and location might help in the diagnosis of a T-GCT, careful assessment is mandatory, especially in unusual locations. [33] (10.1186/s12891-016-1050-7)
  • [L4] Tumors with extension limited to a single site of palmar cortical perforation are classified as grade 3(p) and can be treated with intralesional treatment alone. [35] (10.1016/j.jhsa.2010.07.010)
  • [Case_report] PVNS of the shoulder is extremely rare, with clinical and radiological findings generally being nonspecific and often mimicking a malignancy. [38] (10.1007/s001670050158)
  • [L4] En bloc resection of Campanacci grade III giant cell tumours of the distal radius may reduce the local recurrence rate, and a prosthesis reconstruction is still an alternative option. [40] (10.1186/s12891-025-08851-1)
  • [L4] The satisfactory functional results mirror the status of the underlying joint. [42] (10.1097/01.blo.0000229345.57092.a2)

References

[1] Radiation Therapy for Infiltrative Giant Cell Tumor of the Tendon Sheath. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2012.01.011

[2] Giant cell tumors of the tendon sheaths in the hand: Review of 96 patients with an average follow-up of 12 years. Orthopaedics & Traumatology: Surgery & Research. 2013. DOI: 10.1016/j.otsr.2013.03.008

[3] Giant Cell Tumors of the Tendon Sheaths in the Hand: Review of 96 Patients With an Average Follow-Up of 12 Years. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.08.051

[4] Giant cell tumour of hand bones: outcomes of treatment. Journal of Hand Surgery (European Volume). 2021. DOI: 10.1177/17531934211007820

[5] Is Intralesional Treatment of Giant Cell Tumor of the Distal Radius Comparable to Resection With Respect to Local Control and Functional Outcome?. Clinical Orthopaedics & Related Research. 2015. DOI: 10.1007/s11999-014-4054-3

[6] Tenosynovial Giant Cell Tumor and Pigmented Villonodular Synovitis. Journal of the American Academy of Orthopaedic Surgeons. 2025. DOI: 10.5435/jaaos-d-24-01255

[7] Fibroma of tendon sheath of the hand: a series of 20 patients with 23 tumours. Journal of Hand Surgery (European Volume). 2012. DOI: 10.1177/1753193412469146

[8] Giant cell tumor of tendon sheath in the hand: analysis of risk factors for recurrence in 50 cases. BMC Musculoskeletal Disorders. 2019. DOI: 10.1186/s12891-019-2866-8

[9] THE CLASSIC: Epiphyseal Chondromatous Giant Cell Tumors of the Upper End of the Humerus. Clinical Orthopaedics and Related Research. 2006. DOI: 10.1097/01.blo.0000229309.90265.df

[10] What Affects the Recurrence and Clinical Outcome of Pigmented Villonodular Synovitis?. Clinical Orthopaedics and Related Research. 2006. DOI: 10.1097/01.blo.0000224051.01873.fb

[11] Functional Outcomes of Centralization of the Ulna as a Method of Reconstruction Following Resection of Campanacci Grade 3 Giant Cell Tumor of the Distal Radius. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2022.05.011

[12] Giant Cell Tumor of Bone: Are We Stratifying Results Appropriately?. Clinical Orthopaedics & Related Research. 2012. DOI: 10.1007/s11999-011-2172-8

[13] Campanacci Grade 2 or 3 Giant Cell Tumor of the Phalanges: En Bloc Resection and Matched Nonvascularized Toe Phalangeal Transfer. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2024.06.013

[14] Which Treatment is the Best for Giant Cell Tumors of the Distal Radius? A Meta-analysis. Clinical Orthopaedics & Related Research. 2012. DOI: 10.1007/s11999-012-2464-7

[15] Metachronous Multicentric Giant Cell Tumor: A Case Report and Literature Review. Clinical Orthopaedics & Related Research. 2003. DOI: 10.1097/01.blo.0000068770.86536.e1

[17] Massive wrist prosthesis for giant cell tumour of the distal radius: A case report with a 3-year follow-up. Orthopaedics & Traumatology: Surgery & Research. 2013. DOI: 10.1016/j.otsr.2013.04.001

[18] Local recurrences after curettage and cementing in long bone giant cell tumor. Indian Journal of Orthopaedics. 2011. DOI: 10.4103/0019-5413.77138

[19] Results of Giant Cell Tumor of Bone Treated With Intralesional Excision. Clinical Orthopaedics & Related Research. 2004. DOI: 10.1097/01.blo.0000128280.59965.e3

[20] Extensor Carpi Ulnaris Tenodesis Versus No Stabilization After Wide Resection of Distal Ulna Giant Cell Tumors. HAND. 2017. DOI: 10.1177/1558944717743598

[21] Pigmented villonodular synovitis (giant-cell tumor of the tendon sheath and synovial membrane). A review of eighty-one cases.. The Journal of Bone & Joint Surgery. 1984. DOI: 10.2106/00004623-198466010-00012

[22] Pigmented Villonodular Synovitis of the Hip Managed with Arthroscopic Synovectomy: An Analysis of 19 Cases with up to 10-year Follow-up. Orthopaedic Journal of Sports Medicine. 2019. DOI: 10.1177/2325967119s00413

[25] Recurrence of Giant Cell Tumors in the Hand: A Prospective Study. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2009.12.004

[26] Factors Associated with Recurrent Giant Cell Tumors of the Upper Extremity. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.06.079

[27] Oncologic and functional results after treatment of giant cell tumors of bone. Archives of Orthopaedic and Trauma Surgery. 2001. DOI: 10.1007/s004020100317

[28] Giant cell tumours of the small bones of the hands and feet. The Bone & Joint Journal. 2013. DOI: 10.1302/0301-620x.95b6.30876

[29] Autogenous non-vascularized fibula for treatment of giant cell tumor of distal end radius. Archives of Orthopaedic and Trauma Surgery. 2010. DOI: 10.1007/s00402-010-1059-6

[32] Intralesional nerve-sparing surgery versus non-surgical treatment for giant cell tumor of the sacrum. BMC Musculoskeletal Disorders. 2021. DOI: 10.1186/s12891-021-04907-0

[33] Tenosynovial giant cell tumors in unusual locations detected by positron emission tomography imaging confused with malignant tumors: report of two cases. BMC Musculoskeletal Disorders. 2016. DOI: 10.1186/s12891-016-1050-7

[35] Features of Grade 3 Giant Cell Tumors of the Distal Radius Associated With Successful Intralesional Treatment. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.07.010

[38] Pigmented villonodular synovitis of the shoulder: review and case report. Knee Surgery, Sports Traumatology, Arthroscopy. 1999. DOI: 10.1007/s001670050158

[40] En bloc excision and customized prosthesis replacement for Campanacci III giant cell tumours of the distal radius: five cases report and a review of the literature. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08851-1

[42] Diffuse Pigmented Villonodular Synovitis. Clinical Orthopaedics and Related Research. 2007. DOI: 10.1097/01.blo.0000229345.57092.a2

Creative Commons BY-NC 4.0

CC Creative Commons licence
BY Attribution — you must credit the source
NC NonCommercial — not for commercial use

Attribution-NonCommercial 4.0 International

Creative Commons Corporation ("Creative Commons") is not a law firm and does not provide legal services or legal advice. Distribution of Creative Commons public licenses does not create a lawyer-client or other relationship. Creative Commons makes its licenses and related information available on an "as-is" basis. Creative Commons gives no warranties regarding its licenses, any material licensed under their terms and conditions, or any related information. Creative Commons disclaims all liability for damages resulting from their use to the fullest extent possible.

Using Creative Commons Public Licenses

Creative Commons public licenses provide a standard set of terms and conditions that creators and other rights holders may use to share original works of authorship and other material subject to copyright and certain other rights specified in the public license below. The following considerations are for informational purposes only, are not exhaustive, and do not form part of our licenses.

Considerations for licensors: Our public licenses are intended for use by those authorized to give the public permission to use material in ways otherwise restricted by copyright and certain other rights. Our licenses are irrevocable. Licensors should read and understand the terms and conditions of the license they choose before applying it. Licensors should also secure all rights necessary before applying our licenses so that the public can reuse the material as expected. Licensors should clearly mark any material not subject to the license. This includes other CC- licensed material, or material used under an exception or limitation to copyright. More considerations for licensors: wiki.creativecommons.org/Considerations_for_licensors

Considerations for the public: By using one of our public licenses, a licensor grants the public permission to use the licensed material under specified terms and conditions. If the licensor's permission is not necessary for any reason--for example, because of any applicable exception or limitation to copyright--then that use is not regulated by the license. Our licenses grant only permissions under copyright and certain other rights that a licensor has authority to grant. Use of the licensed material may still be restricted for other reasons, including because others have copyright or other rights in the material. A licensor may make special requests, such as asking that all changes be marked or described. Although not required by our licenses, you are encouraged to respect those requests where reasonable. More considerations for the public: wiki.creativecommons.org/Considerations_for_licensees

Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.