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

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Ang giant cell tumour of tendon sheath ay isang karaniwan, benigno (hindi kanseroso) na bulto sa daliri o hinlalaki. Ano ang sanhi nito, paano ito napapagtukoy at tinatanggal, at gaano kadalas itong bumabalik.

Updated Jun 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.

Ang giant cell tumour of tendon sheath ay isang karaniwang benigno (hindi kanseroso) na bula sa daliri o hinlalaki. Ito ang pangalawang pinakakaraniwang bula sa kamay pagkatapos ng ganglion cyst. Dahan-dahan itong lumalaki, hindi kumakalat sa ibang bahagi ng katawan, at karaniwang tinatanggal gamit ang maliit na operasyon, bagaman maaari itong bumalik minsan. Ipapaliwanag ng pahinang ito kung ano ito, kung paano ito napapagtanto, kung ano ang kasangkot sa pagtatanggal nito, at kung gaano kadalas itong bumalik.

Ano ito

Ang giant cell tumour ng tendon sheath ay lumalago mula sa lining ng tendon sheath o sa katabing kasu-kasuan (ang synovium, ang madulas na tisyu na nagpapahintulot sa mga tendon na dumulas). Ang pangalang "giant cell" ay naglalarawan kung paano ito nakikita sa ilalim ng microscope, kung saan ang mga cluster ng malalaking selula na may maraming nucleus ay halo-halo sa mas maliliit na selula. Ito ay walang kwenta sa kung paano ito kumikilos: ito ay isang benignong paglago na nananatili sa kamay. Minsan tinatawag ito ng mga doktor na localised tenosynovial giant cell tumour.

Saan ito lumalabas at paano ito nararamdaman

Halos laging nasa daliri o hinlalaki ito, madalas sa palad o gilid, malapit sa isa sa mga kasukasuan ng daliri. Karaniwan itong:

  • matigas at parang goma, imbes na malambot, at dahan-dahang lumalaki
  • karaniwang walang sakit, bagama't maaari itong masaktan o mahigpit habang lumalaki
  • solid, kaya (iba sa ganglion na puno ng likido) ay hindi ito nagniningning kapag may ilaw na inilalagay sa kanya

Habang lumalaki ito, maaari nitong gawing mas mahirap ang buong pagliko ng daliri, at minsan ay pumipindot ito sa isang maliit na nerbiyo at nagdudulot ng pamamanhid. Bihasa, ang matagal nang tumour ay bumubuo ng makinis na butas sa buto sa tabi nito, na makikita sa X-ray.

Paano ito napapagtataya

Madalas na makikilala ng iyong manggagamot ang kondisyon sa pamamagitan ng pagsusuri sa bulto. Tumutulong ang ultrasound scan upang kumpirmahin na ito ay solid kaysa sa likido ng ganglion. Para sa mas malaki, mas malalim, o muling lumabas na bulto, ipakikita ng MRI scan kung gaano kalalim ang sakop nito at mayroon itong katangiang anyo (madilim ito sa ilang sequence dahil sa pigment na naglalaman ng bakal sa tissue). Idinadagdag ang X-ray kung tila nakakaapekto ang bulto sa malapit na buto. Tinitiyak ang diagnosis kapag sinuri sa ilalim ng microscope ang tinanggal na bulto.

Paggamot: pag-alis ng buntot

Ang karaniwang gamot ay isang maliit na operasyon upang alisin ito, tinatawag na marginal excision, kadalasan bilang isang day case sa ilalim ng lokal o pangkalahatang anestesia. Sa pamamagitan ng maliit na hiwa, inalis ng doktor ang buong nodule, kasama ang anumang mas maliliit na satellite nodules at ang kasamang sheath, habang maingat na gumagalaw sa paligid ng mga malapit na nerbiyo, ugat ng dugo, at tendon. Ang pag-alis ng buong tumor, imbes na ang kitang-kita lamang na buntot, ang nagbabawas sa pagkakataon na ito ay muling lumitaw. Walang mga tabletang o injeksyon na nagpapaliit ng uri ng buntot na ito.

Gaano kadalas itong bumabalik

Maaaring bumalik ang bulto pagkatapos ng operasyon. Ayon sa mga publikadong serye, humigit-kumulang 1 sa 7 hanggang 1 sa 5 ang bumabalik (humigit-kumulang 10 hanggang 20 sa 100). Mas malaki ang posibilidad ng pagbabalik kung maraming nodule ang mayroon, kung ang tumor ay nakabalot sa mga tendon o buto, o kung may natira na bahagi nito sa unang operasyon. Karamihan sa mga pagbabalik ay lumalabas sa loob ng unang dalawang taon, kaya’t hahawakan ng maigi ng iyong doktor ang lugar sa panahong iyon, bagama’t sa bihirang kaso ay maaari ring bumalik ang bulto sa loob ng maraming taon. Kung ito ay muling magpakita, karaniwang maaari itong tanggalin muli.

Pagbawi

Karamihan sa mga tao ay pumupunta sa bahay sa parehong araw kasama ang isang panata, at minsan ay may magaan na splint. Ang paggalaw ng daliri nang dahan-dahan sa maagang yugto ay tumutulong upang maiwasan ang pagkasikip, at ang isang hand therapist ay maaaring gabayan ito kung kinakailangan. Ang mga tahi ay karaniwang tinatanggal sa loob ng humigit-kumulang dalawang linggo. Inaasahan mong gagamitin ang kamay para sa magaan na mga gawain sa loob ng ilang araw at magpapatuloy sa mas buong paggamit sa loob ng ilang linggo, na gabay ng kaginhawaan at payo ng iyong surgeon. Ang pagprotekta sa peklat mula sa araw at ang pagmamasahe nito kapag gumaling na ay tumutulong upang ito ay maayos.

Mas malalim na pagsusuri

Ang seksyong ito ay lumalabas nang mas malalim, sa antas ng mag-aaral. Hindi ito kinakailangan upang maunawaan o gamutin ang bula, ngunit ipinaliliwanag nito ang mga dahilan kung bakit itong tumubo at kung bakit minsan ay bumabalik.

Ano ang nagpapaunlad ng paglago

Ang giant cell tumour ng tendon sheath ay ang lokal na anyo ng isang pamilya ng mga paglago na tinatawag na tenosynovial giant cell tumours. Ang pinagmumulan nito ay ang sobrang produksyon ng isang signaling protein na tinatawag na CSF1 (colony-stimulating factor 1), na karaniwang sanhi ng maliit na palitan ng genetic material sa pagitan ng mga chromosome sa isang minoridad ng mga selula ng tumor. Ang mga selulang ito ay naglalabas ng CSF1, na humihikayat ng malaking bilang ng mga immune cell (macrophages) mula sa daluyan ng dugo. Karamihan sa bulto ay gawa sa mga nakalap na selulang ito imbes na sa mga orihinal na abnormal na selula, na isang hindi karaniwang paraan kung paano nabubuo ang isang paglago.

Kung paano ito tingnan sa ilalim ng microscope at sa scan

Sa ilalim ng microscope, ang bulto ay isang halo-halong mas maliliit na mononuclear cells, foamy fat-filled macrophages, at ang multinucleated giant cells na nagbigay-daan sa pangalan nito. Naglalaman din ito ng haemosiderin, isang pigment na mayaman sa bakal na natitira mula sa mga maliliit na lumang pagdurugo sa loob ng tissue. Ito ang dahilan kung bakit madalas itong mukhang madilim sa ilang mga MRI sequences, isang katangian na tumutulong upang matukoy ito at hiwalayin mula sa fluid-filled ganglion bago ang anumang operasyon.

Lokal kumpara sa diffuse, at bakit ito ay maaaring mag-recurrence

Ang karaniwang mga bulto sa daliri at hinlalaki ay ang lokal na uri, na may malinaw na hangganan at karaniwang kumpleto ang pag-alis. Ang mas bihirang diffuse na uri ay kumakalat nang mas malawak sa pamamagitan ng lining ng isang kasu-kasuan (parehong proseso na, sa isang malaking kasu-kasuan, tinatawag na pigmented villonodular synovitis). Mas mahirang alisin nang kumpleto ang diffuse na uri at mas madalas itong bumalik. Kahit ang lokal na uri ay maaaring bumalik kung may maliliit na satellite nodule na naiwan, kaya’t inaalisan ng buong bulto at ang kasamang sheath sa paligid nito ng kumpleto ang surgeon imbes na alisin lamang ang malinaw na bahagi.

Kapag may papel ang mga tabletang gamot

Para sa bihirang mga diffuse na tumor na hindi maalis sa pamamagitan ng operasyon, o kung paulit-ulit itong bumabalik, ang mga gamot na humahadlang sa CSF1 signal (CSF1-receptor inhibitors) ay maaari nitong bawasan ang laki nito. Ang mga ito ay inilaan lamang para sa mahihirap na kaso at hindi ginagamit para sa karaniwang, madaling alisin na buntong sa daliri, na direktang pinapagaling ng operasyon.

Kailan kumonsulta sa doktor

Kumonsulta sa iyong GP o hand surgeon kung mayroon kang matigas na buntong sa daliri o hinlalaki na hindi nawawala, dahan-dahang lumalaki, naghihigpit sa galaw ng daliri, o nagdudulot ng pamamanhid o pangangati. Pagkatapos ng operasyon, ipaalam sa iyong surgeon kung mapansin mo ang bagong buntong sa loob o malapit sa peklat, dahil maaari itong senyales na bumabalik ang tumor at mahalagang suriin agad.

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

Overview

  • Giant cell tumour of tendon sheath is a common benign tumour of the hand [2].
  • Reports of giant cell tumour of tendon sheath in the paediatric population are rare [2].
  • Giant cell tumour of tendon sheath can be locally recurrent after excision [2].
  • Imaging studies can be of little utility in distinguishing glomus tumors from other lesions like giant cell tumor of the tendon sheath [5].
  • Vigilance for malignancy is encouraged for lesions such as giant cell tumors, as aggressive treatment such as wide excision or amputation may be necessary to prevent recurrence [1].
  • Orthopaedic surgeons should be familiar with the spectrum of hand and wrist tumors, the work-up necessary to arrive at a precise diagnosis, and the treatment that will achieve the most favorable outcome [6].

Anatomy & Pathophysiology

  • Giant cell tumors are classified as benign bony and soft tissue tumors of the hand [1].
  • Giant cell tumors can exhibit aggressive behavior requiring wide excision or amputation to prevent recurrence [1].
  • Giant cell tumors can recur at the third lumbar vertebra [22].
  • If the vertebral body and posterior arch are affected in giant cell tumors, curettage is insufficient to prevent recurrence [22].
  • Giant cell tumors can occur in the proximal phalanx [23].
  • Giant cell tumors can recur in the second metacarpal [42].
  • Primary parosteal osteosarcoma of the finger is a rare tumor with characteristic radiographic and microscopic appearance [36].
  • Fibroma of tendon sheath (FTS) is an extremely rare condition in the hand of a 3-year-old child [39].
  • Florid reactive periostitis presents as soft tissue swelling adjacent to hand bones with pseudomalignant or pseudoinflammatory features [45].

Classification

  • Giant cell tumour of tendon sheath is a common benign tumour of the hand [2].
  • Giant cell tumour of tendon sheath can be locally recurrent after excision [2].
  • Reports of giant cell tumour of tendon sheath in the paediatric population are rare [2].
  • Imaging studies can be of little utility in distinguishing glomus tumors from other lesions like giant cell tumor of the tendon sheath [5].

Clinical Presentation

  • Giant cell tumour of tendon sheath is a common benign tumour of the hand [2].
  • Reports of giant cell tumour of tendon sheath in the paediatric population are rare [2].
  • Giant cell tumour of tendon sheath can be locally recurrent after excision [2].
  • Imaging studies can be of little utility in distinguishing glomus tumors from other lesions like giant cell tumor of the tendon sheath [5].
  • Prolonged and atypical swelling of soft tissue, even with a previous traumatic lesion, may indicate underlying malignancy, necessitating proper imaging before surgery [13].
  • Primary bone and soft-tissue tumors that mimic common sports injuries are relatively rare but can be easily missed, leading to limb- and life-threatening consequences [20].
  • Vigilance for malignancy is encouraged for lesions like giant cell tumors to prevent recurrence [1].
  • Orthopaedic surgeons should be familiar with the spectrum of hand and wrist tumors, the work-up necessary to arrive at a precise diagnosis, and the treatment that will achieve the most favorable outcome [6].
  • Soft tissue sarcomas of the hand may have better survival than those at other sites, but prognosis must be interpreted with caution due to the rarity of the condition [9].
  • An unusual pathway for spread of squamous cell carcinoma from the thumb to the small finger is via the flexor tendon sheaths, which should be considered in the evaluation of patients with hand tumors [15].
  • Local recurrence is seen in ≤20% of cases of giant cell tumor of bone [29].
  • A second local intralesional procedure is typically sufficient in cases of giant cell tumor of bone detected early [29].
  • Most recurrences of giant-cell tumor of bone can be expected within the first two years [12].
  • Some patients with giant-cell tumor of bone remain at risk for recurrence for a much longer period, with recurrences occurring nineteen to thirty years after initial treatment [12].
  • Two cases of soft-tissue recurrence of giant-cell tumor within a surgical scar indicate that tumor cells may be implanted in a surgical wound [3].
  • 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 [7].
  • Malignant transformation of a giant cell tumor of bone while receiving denosumab treatment is a rare but important possibility [16].

Investigations

  • Imaging studies have limited utility in distinguishing glomus tumors from other lesions such as giant cell tumor of the tendon sheath [5].
  • Prolonged and atypical soft tissue swelling, even in the presence of a previous traumatic lesion, may indicate underlying malignancy and necessitates proper imaging before surgery [13].
  • The use of CT and whole body bone scans may be beneficial when indicated, particularly after the occurrence of a second tumor focus [38].

Treatment

  • Vigilance for malignancy is encouraged, and aggressive treatment such as wide excision or amputation may be necessary for certain lesions like giant cell tumors to prevent recurrence [1].
  • Giant cell tumour of tendon sheath is a common benign tumour of the hand that can be locally recurrent after excision [2].
  • Two cases of soft-tissue recurrence of giant-cell tumor within a surgical scar are reported, indicating that tumor cells may be implanted in a surgical wound [3].
  • Despite its benign histology, giant cell tumor of bone is an aggressive tumor that demands meticulous attention to surgical detail and close postoperative surveillance for successful local tumor control and durable, joint-preserving function [4].
  • 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 [8].
  • The transplantation of a toe phalanx for a recurrent giant-cell tumor in a skeletally immature patient resulted in a satisfactory outcome with full hand function and no tumor recurrence forty-one years later [10].
  • 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 [11].
  • Although most recurrences of giant-cell tumor of bone can be expected within the first two years, some patients remain at risk for a much longer period, with recurrences occurring nineteen to thirty years after initial treatment [12].
  • Wide excision should be considered in the presence of extensive soft tissue involvement, and early treatment yields good results [14].
  • The available studies suffer from selection bias and are inadequate to answer questions regarding the appropriate use, duration, and efficacy of denosumab in giant cell tumors of bone definitively [17].
  • The effectiveness of treatment of a recurrence with either an intralesional or a wide excisional procedure does not appear to be diminished by initial curettage and cementing [18].
  • Treatment is directed at controlling the lesion locally, with curettage and adjuvant therapy being the primary goal for most lesions to preserve the articular surface [19].
  • Giant-cell tumor of bone was effectively treated with megavoltage radiation in patients in whom operative resection would have been difficult or was not feasible, with a ten-year lack of progression rate of 85 percent [21].
  • Radiation therapy is a safe and effective treatment option for benign giant cell tumors of bone [27].
  • 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 [31].
  • This tumor should be treated with conservative but thorough excision [32].
  • The authors recommend intralesional surgery with polymethylmethacrylate for the majority of primary GCTs [33].

Complications

  • Giant cell tumour of tendon sheath is a common benign tumour of the hand that can be locally recurrent after excision [2].
  • Reports of giant cell tumour of tendon sheath in the paediatric population are rare [2].
  • Soft-tissue recurrence of giant-cell tumor within a surgical scar indicates that tumor cells may be implanted in a surgical wound [3].
  • Giant cell tumor of bone is an aggressive tumor that demands meticulous attention to surgical detail and close postoperative surveillance for successful local tumor control and durable, joint-preserving function [4].
  • 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 [7].
  • 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 treatment morbidity while maximizing disease control [8].
  • The transplantation of a toe phalanx for a recurrent giant-cell tumor in a skeletally immature patient resulted in a satisfactory outcome with full hand function and no tumor recurrence forty-one years later [10].
  • Although most recurrences of giant-cell tumor of bone can be expected within the first two years, some patients remain at risk for a much longer period, with recurrences occurring nineteen to thirty years after initial treatment [12].
  • Prolonged and atypical swelling of soft tissue, even with a previous traumatic lesion, may indicate underlying malignancy, necessitating proper imaging before surgery [13].
  • The available studies regarding treatment with denosumab suffer from selection bias and are inadequate to answer questions regarding the appropriate use, duration, and efficacy of denosumab in giant cell tumors of bone definitively [17].

Recovery

  • Giant cell tumour of tendon sheath is a common benign tumour of the hand that can be locally recurrent after excision [2].
  • Reports of giant cell tumour of tendon sheath in the paediatric population are rare [2].
  • Two cases of soft-tissue recurrence of giant-cell tumor within a surgical scar indicate that tumor cells may be implanted in a surgical wound [3].
  • Despite its benign histology, giant cell tumor of bone is an aggressive tumor that demands meticulous attention to surgical detail and close postoperative surveillance for successful local tumor control and durable, joint-preserving function [4].
  • 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 [7].
  • Although most recurrences of giant-cell tumor of bone can be expected within the first two years, some patients remain at risk for a much longer period, with recurrences occurring nineteen to thirty years after initial treatment [12].
  • The transplantation of a toe phalanx for a recurrent giant-cell tumor in a skeletally immature patient resulted in a satisfactory outcome with full hand function and no tumor recurrence forty-one years later [10].
  • The effectiveness of treatment of a recurrence with either an intralesional or a wide excisional procedure does not appear to be diminished by initial curettage and cementing [18].

Key Evidence

  • [L5] Vigilance for malignancy is encouraged, and aggressive treatment such as wide excision or amputation may be necessary for certain lesions like giant cell tumors to prevent recurrence. [1] (10.1016/j.jhsa.2010.08.015)
  • [L4] Giant cell tumour of tendon sheath is a common benign tumour of the hand that can be locally recurrent after excision, and reports in the paediatric population are rare, with this case believed to be the youngest reported. [2] (10.1177/1753193412455792)
  • [L4] Two cases of soft-tissue recurrence of giant-cell tumor within a surgical scar are reported, indicating that tumor cells may be implanted in a surgical wound. [3] (10.2106/00004623-196749020-00016)
  • [L3] Despite its benign histology, giant cell tumor of bone is an aggressive tumor that demands meticulous attention to surgical detail and close postoperative surveillance for successful local tumor control and durable, joint-preserving function. [4] (10.1097/01.blo.0000180055.76969.08)
  • [Case_report] Imaging studies can be of little utility in distinguishing glomus tumors from other lesions like giant cell tumor of the tendon sheath. [5] (10.1016/j.jhsa.2012.02.035)
  • [L5] Orthopaedic surgeons should be familiar with the spectrum of these tumors, the work-up necessary to arrive at a precise diagnosis, and the treatment that will achieve the most favorable outcome. [6] (10.5435/00124635-200611000-00013)
  • [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. [7] (10.1007/s11999-011-2172-8)
  • [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. [8] (10.1177/17531934211007820)
  • [L5] It notes that while soft tissue sarcomas of the hand may have better survival than those at other sites, prognosis must be interpreted with caution due to the rarity of the condition. [9] (10.1016/j.jhsa.2010.08.014)
  • [Case_report] The transplantation of a toe phalanx for a recurrent giant-cell tumor in a skeletally immature patient resulted in a satisfactory outcome with full hand function and no tumor recurrence forty-one years later. [10] (10.2106/00004623-199412000-00015)
  • [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. [11] (10.1007/s11999-014-4054-3)
  • [L4] Although most recurrences of giant-cell tumor of bone can be expected within the first two years, some patients remain at risk for a much longer period, with recurrences occurring nineteen to thirty years after initial treatment. [12] (10.2106/00004623-199408000-00013)
  • [L5] Prolonged and atypical swelling of soft tissue, even with a previous traumatic lesion, may indicate underlying malignancy, necessitating proper imaging before surgery. [13] (10.1016/j.csm.2013.03.008)
  • [Case_report] Wide excision should be considered in the presence of extensive soft tissue involvement, and early treatment yields good results. [14] (10.1016/j.jhsa.2014.01.004)
  • [L5] This unusual pathway should be considered in the evaluation of patients with hand tumors. [15] (10.1016/j.jhsa.2009.06.012)
  • [L4] Malignant transformation of a giant cell tumor of bone while receiving denosumab treatment is a rare but important possibility that physicians should be aware of, as denosumab is increasingly used for this condition. [16] (10.1007/s11999-015-4249-2)
  • [L5] The available studies suffer from selection bias and are inadequate to answer questions regarding the appropriate use, duration, and efficacy of denosumab in giant cell tumors of bone definitively. [17] (10.1097/corr.0000000000001217)
  • [L3] Furthermore, the effectiveness of treatment of a recurrence with either an intralesional or a wide excisional procedure does not appear to be diminished by initial curettage and cementing. [18] (10.2106/00004623-199412000-00009)
  • [L4] Treatment is directed at controlling the lesion locally, with curettage and adjuvant therapy being the primary goal for most lesions to preserve the articular surface. [19] (10.1016/j.hcl.2004.03.016)
  • [L5] Primary bone and soft-tissue tumors that mimic common sports injuries are relatively rare but can be easily missed, leading to limb- and life-threatening consequences. [20] (10.5435/jaaos-22-04-223)
  • [L4] Giant-cell tumor of bone was effectively treated with megavoltage radiation in patients in whom operative resection would have been difficult or was not feasible, with a ten-year lack of progression rate of 85 percent. [21] (10.2106/00004623-199911000-00008)
  • [L5] If the vertebral body and the posterior arch are affected, curettage of the lesion is insufficient to prevent tumor recurrence. [22] (10.1016/j.otsr.2010.05.009)
  • [L4] The application of a temporary dorsal plaster backslab to unstable distal radius fractures causes insignificant further displacement. [23] (10.1177/1753193408097859)
  • [L4] The authors conclude that radiation therapy is a safe and effective treatment option for benign giant cell tumors of bone. [27] (10.1097/01.blo.0000069890.31220.b4)
  • [L5] Local recurrence is seen in ≤20% of cases, and a second local intralesional procedure is typically sufficient in cases that are detected early. [29] (10.5435/jaaos-21-02-118)
  • [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. [31] (10.1007/s00402-010-1059-6)
  • [L4] This tumor should be treated with conservative but thorough excision. [32] (10.1097/01.blo.0000129555.37075.74)
  • [L3] The authors recommend intralesional surgery with polymethylmethacrylate for the majority of primary GCTs. [33] (10.1007/s11999-010-1501-7)
  • [L4] Primary parosteal osteosarcoma of the finger is a rare tumor with characteristic radiographic and microscopic appearance. [36] (10.1016/j.jhsa.2019.08.006)
  • [L4] The use of CT and whole body bone scans may prove beneficial when indicated, particularly after the occurrence of a second tumor focus. [38] (10.1097/01.blo.0000063784.32430.b0)
  • [Case_report] We experienced an extremely rare case of FTS in the hand of a 3-year-old child. [39] (10.1186/s12891-020-03728-x)
  • [L4] Reversed vascularised toe joint transfer should be considered as an option for reconstruction of joint defects in a single finger, especially in a young active patient, and has shown good short- to medium-term results. [42] (10.1177/1753193408089048)
  • [L4] Florid reactive periostitis should be considered in cases of soft tissue swelling adjacent to hand bones showing pseudomalignant or pseudoinflammatory features. [45] (10.1016/j.jhsa.2013.08.115)

References

[1] Benign Bony and Soft Tissue Tumors of the Hand. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.08.015 [2] Giant cell tumour of tendon sheath in a 4-year-old boy. Journal of Hand Surgery (European Volume). 2012. DOI: 10.1177/1753193412455792 [3] Soft-Tissue Recurrence of Giant-Cell Tumor of Bone after Irridiation and Excision. The Journal of Bone & Joint Surgery. 1967. DOI: 10.2106/00004623-196749020-00016 [4] Impact Severity of Local Recurrence in Giant Cell Tumor of Bone. Clinical Orthopaedics and Related Research. 2005. DOI: 10.1097/01.blo.0000180055.76969.08 [5] Glomus Tumor of Digital Nerve: Case Report. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2012.02.035 [6] Malignant Tumors of the Hand and Wrist. Journal of the American Academy of Orthopaedic Surgeons. 2006. DOI: 10.5435/00124635-200611000-00013 [7] Giant Cell Tumor of Bone: Are We Stratifying Results Appropriately?. Clinical Orthopaedics & Related Research. 2012. DOI: 10.1007/s11999-011-2172-8 [8] Giant cell tumour of hand bones: outcomes of treatment. Journal of Hand Surgery (European Volume). 2021. DOI: 10.1177/17531934211007820 [9] Malignant and Metastatic Tumors of the Hand. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.08.014 [10] Phalangeal transfer for recurrent giant-cell tumor of the phalanx of a finger in a nine-year-old child. A case report with forty-one-year follow-up.. The Journal of Bone & Joint Surgery. 1994. DOI: 10.2106/00004623-199412000-00015 [11] 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 [12] Late recurrence of giant-cell tumor of bone. A report of four cases.. The Journal of Bone & Joint Surgery. 1994. 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