Skip to content

Patients › Hand

U tế bào khổng lồ của bao gân (Cục u ở ngón tay hoặc ngón cái)

PDF Evidence

U bào khổng lồ bao hoạt gân là một khối u lành tính (không phải ung thư) phổ biến ở ngón tay hoặc ngón cái. Nguyên nhân gây ra khối u này là gì, cách chẩn đoán và loại bỏ nó, cũng như tần suất tái phát.

Updated Jun 2026
Một minh họa vẽ tay về một khối u lành tính ở bên cạnh ngón tay.
Dưới kính hiển vi, u tế bào khổng lồ của bao gân được cấu tạo từ các cụm tế bào khổng lồ đa nhân (những tế bào có màu sẫm, trông gồ ghề) trộn lẫn với các tế bào đơn nhân nhỏ hơn. Khối u này lành tính, và chính hình thái tế bào khổng lồ này là cơ sở đặt tên cho tổn thương. Kieran Hirpara 4.0

Trang này được dịch bằng máy và chưa được bác sĩ kiểm tra. Bản tiếng Anh là bản chính thức.

U bào khổng lồ bao hoạt gân là một khối u lành tính (không ung thư) phổ biến ở ngón tay hoặc ngón cái. Đây là khối u phổ biến thứ hai ở bàn tay sau u nang. Khối u này phát triển chậm, không di căn đến các bộ phận khác của cơ thể và thường được loại bỏ bằng một phẫu thuật nhỏ, mặc dù đôi khi nó có thể tái phát. Trang này giải thích khối u là gì, cách chẩn đoán, quy trình loại bỏ và tần suất tái phát.

Định nghĩa

U tế bào khổng lồ của bao gân phát triển từ lớp lót của bao gân hoặc khớp lân cận (màng hoạt dịch, mô trơn giúp gân trượt dễ dàng). Tên gọi "tế bào khổng lồ" mô tả hình thái dưới kính hiển vi, nơi các cụm tế bào lớn, đa nhân được trộn lẫn với các tế bào nhỏ hơn. Điều này không phản ánh hành vi của khối u: đây là một khối u lành tính, chỉ giới hạn ở bàn tay. Các bác sĩ đôi khi gọi nó là u tế bào khổng lồ hoạt dịch khu trú.

Vị trí xuất hiện và cảm giác

Khối u hầu như luôn xuất hiện ở ngón tay hoặc ngón cái, thường ở mặt lòng hoặc mặt bên, gần một trong các khớp ngón tay. Thông thường, khối u có các đặc điểm sau:

  • cứng và đàn hồi (như cao su), chứ không mềm, và phát triển chậm
  • thường không gây đau, mặc dù có thể gây đau âm ỉ hoặc cảm giác bị kẹt khi khối u to lên
  • cứng đặc, do đó (khác với u nang chứa dịch) khối u không phát sáng khi soi đèn pin áp vào

Khi khối u phát triển, nó có thể gây khó khăn cho việc gập ngón tay hoàn toàn, và đôi khi chèn ép vào một dây thần kinh nhỏ, gây cảm giác tê bì. Hiếm gặp hơn, khối u tồn tại lâu ngày có thể tạo thành một hốc lõm, mịn trên xương bên cạnh, và biểu hiện rõ trên phim X-quang.

Cách chẩn đoán

Bác sĩ phẫu thuật thường có thể nhận biết khối u này thông qua việc khám lâm sàng. Siêu âm giúp xác nhận rằng khối u là mô đặc thay vì dịch của u nang khớp (ganglion). Đối với các khối u lớn hơn, nằm sâu hoặc tái phát, chụp cộng hưởng từ (MRI) cho thấy mức độ lan rộng và có đặc điểm khá đặc trưng (khối u có tín hiệu thấp trên một số chuỗi xung do sắc tố chứa sắt trong mô). Chụp X-quang được chỉ định thêm nếu khối u có vẻ liên quan đến xương lân cận. Chẩn đoán được xác nhận chắc chắn khi mẫu mô khối u đã được cắt bỏ được soi dưới kính hiển vi.

Điều trị: loại bỏ khối u

Phương pháp điều trị thông thường là một phẫu thuật nhỏ để loại bỏ khối u, được gọi là cắt bỏ rìa, thường được thực hiện như một ca phẫu thuật ngày dưới gây tê tại chỗ hoặc gây mê toàn thân. Thông qua một vết rạch nhỏ, bác sĩ phẫu thuật loại bỏ toàn bộ nốt sần, cùng với bất kỳ nốt sần nhỏ nào khác (nốt vệ tinh) và bao gân liên quan, đồng thời thao tác cẩn thận xung quanh các dây thần kinh, mạch máu và gân gần đó. Việc loại bỏ toàn bộ khối u, thay vì chỉ loại bỏ khối u rõ ràng, là yếu tố làm giảm nguy cơ tái phát. Không có loại thuốc uống hoặc tiêm nào có thể làm cho loại khối u này co lại.

Tần suất tái phát

Khối u này có thể tái phát sau phẫu thuật. Theo các nghiên cứu đã công bố, khoảng 1 trong 7 đến 1 trong 5 trường hợp bị tái phát (tương đương 10 đến 20 trên 100 ca). Tái phát có nhiều khả năng xảy ra hơn khi có nhiều nốt u, khi khối u bao quanh gân hoặc xương, hoặc khi một phần khối u còn sót lại sau cuộc phẫu thuật đầu tiên. Hầu hết các trường hợp tái phát xuất hiện trong hai năm đầu, đó là lý do tại sao bác sĩ phẫu thuật sẽ theo dõi khu vực này trong giai đoạn đó, mặc dù trong những trường hợp hiếm, khối u có thể tái phát sau nhiều năm. Nếu khối u tái phát, nó thường có thể được loại bỏ lại.

Phục hồi

Hầu hết mọi người có thể về nhà trong cùng ngày với băng gạc, và đôi khi là một nẹp nhẹ. Việc vận động nhẹ nhàng ngón tay sớm giúp ngăn ngừa cứng khớp, và một chuyên trị liệu tay có thể hướng dẫn điều này nếu cần. Chỉ khâu thường được tháo bỏ sau khoảng hai tuần. Bạn có thể mong đợi sử dụng tay cho các công việc nhẹ trong vòng vài ngày và dần dần quay lại sử dụng bình thường trong vài tuần, dựa trên mức độ thoải mái và lời khuyên của bác sĩ phẫu thuật. Bảo vệ vết sẹo khỏi ánh nắng mặt trời và mát-xa vết sẹo sau khi đã lành giúp vết sẹo ổn định hơn.

Tìm hiểu sâu hơn

Phần này đi sâu hơn ở mức độ sinh viên. Phần này không cần thiết để hiểu hoặc điều trị khối u, nhưng nó giải thích nguyên nhân gây ra khối u này và tại sao đôi khi nó tái phát.

Những yếu tố thúc đẩy sự phát triển

U khổng lồ tế bào bao gân là dạng khu trú của một nhóm các khối u được gọi là u khổng lồ màng hoạt dịch. Động lực chính của các khối u này là sự sản xuất quá mức một protein tín hiệu gọi là CSF1 (yếu tố kích thích tạo khuẩn lạc 1), thường được kích hoạt bởi một sự trao đổi nhỏ vật liệu di truyền giữa các nhiễm sắc thể ở một tỷ lệ nhỏ các tế bào khối u. Các tế bào này giải phóng CSF1, thu hút số lượng lớn tế bào miễn dịch (đại thực bào) từ máu. Phần lớn khối u thực chất được cấu tạo từ các tế bào được huy động này chứ không phải từ các tế bào bất thường ban đầu, đây là một cơ chế hình thành khối u khá khác thường.

Hình ảnh dưới kính hiển vi và trên phim chụp

Dưới kính hiển vi, khối u là sự kết hợp của các tế bào đơn nhân nhỏ, các đại thực bào chứa mỡ dạng bọt và các tế bào khổng lồ nhiều nhân, là yếu tố đặt tên cho khối u. Khối u cũng chứa sắt hemosiderin, một sắc tố giàu sắt còn lại sau các lần xuất huyết nhỏ cũ trong mô. Sắt này là lý do khiến khối u thường xuất hiện tối trên một số chuỗi xung MRI, một đặc điểm giúp phân biệt nó với nang dịch trước khi phẫu thuật.

Cục khu trú so với khuếch tán, và lý do tại sao có thể tái phát

Các khối u ngón tay và ngón cái phổ biến thuộc loại khu trú, có ranh giới rõ ràng và thường được loại bỏ hoàn toàn. Một loại khuếch tán ít phổ biến hơn lan rộng hơn qua lớp màng hoạt dịch của khớp (cùng quá trình này, ở các khớp lớn, được gọi là viêm hoạt dịch nốt gai sắc tố). Loại khuếch tán khó loại bỏ hoàn toàn hơn và có xu hướng tái phát thường xuyên hơn. Ngay cả loại khu trú cũng có thể tái phát nếu các nốt nhỏ vệ tinh bị bỏ sót, đó là lý do tại sao bác sĩ phẫu thuật loại bỏ toàn bộ khối u và bao hoạt dịch liên quan xung quanh nó thay vì chỉ phần rõ ràng.

Khi thuốc viên đóng vai trò

Đối với các khối u khuếch tán hiếm gặp không thể loại bỏ bằng phẫu thuật hoặc có xu hướng tái phát, các loại thuốc ức chế tín hiệu CSF1 (chất ức chế thụ thể CSF1) có thể làm thu nhỏ chúng. Những loại thuốc này chỉ dành cho các trường hợp khó điều trị và không được sử dụng cho các khối u ngón tay thông thường, dễ dàng loại bỏ, vốn đã được xử lý trực tiếp bằng phẫu thuật.

Khi nào cần gặp bác sĩ

Hãy gặp bác sĩ đa khoa hoặc bác sĩ phẫu thuật tay nếu bạn có một khối u chắc ở ngón tay hoặc ngón cái không biến mất, phát triển chậm, hạn chế cử động của ngón tay, hoặc gây tê bì hoặc kiến bò. Sau phẫu thuật, hãy thông báo cho bác sĩ phẫu thuật của bạn nếu bạn nhận thấy một khối u mới xuất hiện trong hoặc gần vết sẹo, vì đây có thể là dấu hiệu khối u đang tái phát và cần được kiểm tra sớm.

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. DOI: 10.2106/00004623-199408000-00013 [13] Dilemmas in Distinguishing Between Tumor and the Posttraumatic Lesion with Surgical or Pathologic Correlation. Clinics in Sports Medicine. 2013. DOI: 10.1016/j.csm.2013.03.008 [14] Superficial Angiomyxoma of the Thumb Mimicking a Malignant Bone Tumor: Case Report. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2014.01.004 [15] Spread of Squamous Cell Carcinoma From the Thumb to the Small Finger via the Flexor Tendon Sheaths. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2009.06.012 [16] A High-grade Sarcoma Arising in a Patient With Recurrent Benign Giant Cell Tumor of the Proximal Tibia While Receiving Treatment With Denosumab. Clinical Orthopaedics & Related Research. 2015. DOI: 10.1007/s11999-015-4249-2 [17] CORR Insights®: Is Treatment with Denosumab Associated with Local Recurrence in Patients with Giant Cell Tumor of Bone Treated with Curettage? A Systematic Review. Clinical Orthopaedics & Related Research. 2020. DOI: 10.1097/corr.0000000000001217 [18] Recurrence of giant-cell tumors of the long bones after curettage and packing with cement.. The Journal of Bone & Joint Surgery. 1994. DOI: 10.2106/00004623-199412000-00009 [19] Aneurysmal bone cyst and giant cell tumor of bone of the hand and distal radius. Hand Clinics. 2004. DOI: 10.1016/j.hcl.2004.03.016 [20] Oncologic Conditions That Simulate Common Sports Injuries. Journal of the American Academy of Orthopaedic Surgeons. 2014. DOI: 10.5435/jaaos-22-04-223 [21] Megavoltage Radiation Therapy for Axial and Inoperable Giant-Cell Tumor of Bone. The Journal of Bone & Joint Surgery. 1999. DOI: 10.2106/00004623-199911000-00008 [22] Giant cells tumor recurrence at the third lumbar vertebra. Orthopaedics & Traumatology: Surgery & Research. 2010. DOI: 10.1016/j.otsr.2010.05.009 [23] Resection of a giant cell tumour of the proximal phalanx and reconstruction by iliac crest graft. Journal of Hand Surgery (European Volume). 2009. DOI: 10.1177/1753193408097859 [27] Radiation Therapy for Giant Cell Tumors of Bone. Clinical Orthopaedics & Related Research. 2003. DOI: 10.1097/01.blo.0000069890.31220.b4 [29] Giant Cell Tumor of Bone. Journal of the American Academy of Orthopaedic Surgeons. 2013. DOI: 10.5435/jaaos-21-02-118 [31] 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] Skeletal Metastasis in Tricholemmal Carcinoma. Clinical Orthopaedics & Related Research. 2004. DOI: 10.1097/01.blo.0000129555.37075.74 [33] Giant Cell Tumor of Bone: Risk Factors for Recurrence. Clinical Orthopaedics & Related Research. 2011. DOI: 10.1007/s11999-010-1501-7 [36] Parosteal Osteosarcoma of the Proximal Phalanx of a Finger. The Journal of Hand Surgery. 2020. DOI: 10.1016/j.jhsa.2019.08.006 [38] Multicentric Giant Cell Tumor of Bone: A Case Report and Review of the Literature. Clinical Orthopaedics & Related Research. 2003. DOI: 10.1097/01.blo.0000063784.32430.b0 [39] Fibroma of tendon sheath of the hand in a 3-year-old boy: a case report. BMC Musculoskeletal Disorders. 2020. DOI: 10.1186/s12891-020-03728-x [42] Vascularised Joint Transfer in the Management of Recurrent Giant Cell Tumour of the Second Metacarpal. Journal of Hand Surgery (European Volume). 2008. DOI: 10.1177/1753193408089048 [45] Florid Reactive Periostitis of the Metacarpal and Phalanx: 2 Case Reports. The Journal of Hand Surgery*. 2013. DOI: 10.1016/j.jhsa.2013.08.115

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.