Abstract：
Tenosynovial giant cell tumor (TGCT) is a benign proliferative disease affecting synovial membranes. There are 2 forms, localized (L-TGCT) and diffuse (D-TGCT), which although histologically similar behave differently. It is locally invasive and is treated in most cases by operative excision. The aim of this study was to assess current practice, how the patients\' presentation affected their outcome, as well as review the recurrence rates and complications.
A retrospective analysis of 123 cases was performed in patients treated between 2003 and 2019 with TGCT of the foot and/or ankle. Data were collected on age at presentation, radiologic pattern of disease, location of disease, treatment provided, and recurrence rates. The minimum follow-up was 2 years with a mean of 7.7 years.
There were 61.7% female patients with a mean age of 39 (range, 11-76) years. L-TGCT accounted for 85 (69.1%) cases and D-TGCT for 38 (30.9%). The most prevalent preoperative symptoms were a palpable mass (78/123) and pain (65/123). Radiologically confirmed recurrence in the operative group was noted in 14.5% (16/110) cases. This comprised 4% (3/75) of operatively treated L-TGCT and 37% (13/35) of operatively treated D-TGCT. Patients with pain on presentation and those with erosive changes on presenting magnetic resonance imaging (MRI) were more likely to have persistent postoperative pain (P < .001 for both). Where patients had both preoperative pain and erosive changes, 57.1% had postoperative pain. Thirteen cases were managed nonoperatively where symptoms were minimal, with 1 case requiring surgery at a later date.
Outcomes of TGCT management are dependent on the disease type, extent of preoperative erosive changes, and presence of preoperative pain. These data are useful for counseling patients regarding the outcomes of surgical intervention and help guide the timing of intervention.
Level III, retrospective cohort study.
A retrospective analysis of 123 cases was performed in patients treated between 2003 and 2019 with TGCT of the foot and/or ankle. Data were collected on age at presentation, radiologic pattern of disease, location of disease, treatment provided, and recurrence rates. The minimum follow-up was 2 years with a mean of 7.7 years.
There were 61.7% female patients with a mean age of 39 (range, 11-76) years. L-TGCT accounted for 85 (69.1%) cases and D-TGCT for 38 (30.9%). The most prevalent preoperative symptoms were a palpable mass (78/123) and pain (65/123). Radiologically confirmed recurrence in the operative group was noted in 14.5% (16/110) cases. This comprised 4% (3/75) of operatively treated L-TGCT and 37% (13/35) of operatively treated D-TGCT. Patients with pain on presentation and those with erosive changes on presenting magnetic resonance imaging (MRI) were more likely to have persistent postoperative pain (P < .001 for both). Where patients had both preoperative pain and erosive changes, 57.1% had postoperative pain. Thirteen cases were managed nonoperatively where symptoms were minimal, with 1 case requiring surgery at a later date.
Outcomes of TGCT management are dependent on the disease type, extent of preoperative erosive changes, and presence of preoperative pain. These data are useful for counseling patients regarding the outcomes of surgical intervention and help guide the timing of intervention.
Level III, retrospective cohort study.
摘要：
■肌腱滑膜巨细胞瘤（TGCT）是一种影响滑膜的良性增殖性疾病。有两种形式，局部（L-TGCT）和弥漫性（D-TGCT），虽然组织学相似，但表现不同。它是局部侵入性的，在大多数情况下通过手术切除治疗。这项研究的目的是评估当前的实践，患者的表现如何影响他们的结果，以及回顾复发率和并发症。
■对2003年至2019年间接受足和/或踝关节TGCT治疗的123例患者进行了回顾性分析。数据收集了演示时的年龄，疾病的放射学模式，疾病的位置，提供治疗,和复发率。最少随访2年，平均7.7年。
■有61.7%的女性患者，平均年龄为39岁(范围，11-76）年。L-TGCT占85例(69.1%),D-TGCT占38例(30.9%)。术前最常见的症状是明显的肿块（78/123）和疼痛（65/123）。手术组经放射学证实复发的病例为14.5%(16/110)。这包括4%(3/75)的手术治疗的L-TGCT和37%(13/35)的手术治疗的D-TGCT。表现为疼痛的患者和表现为磁共振成像（MRI）的糜烂性改变的患者更有可能出现持续性术后疼痛（两者均P<0.001）。患者术前既有疼痛又有糜烂改变，57.1%有术后疼痛。13例患者接受了非手术治疗，症状轻微，1例以后需要手术。
■TGCT管理的结果取决于疾病类型，术前糜烂改变的程度，和术前疼痛的存在。这些数据可用于指导患者手术干预的结果，并有助于指导干预的时机。
■三级,回顾性队列研究。
■对2003年至2019年间接受足和/或踝关节TGCT治疗的123例患者进行了回顾性分析。数据收集了演示时的年龄，疾病的放射学模式，疾病的位置，提供治疗,和复发率。最少随访2年，平均7.7年。
■有61.7%的女性患者，平均年龄为39岁(范围，11-76）年。L-TGCT占85例(69.1%),D-TGCT占38例(30.9%)。术前最常见的症状是明显的肿块（78/123）和疼痛（65/123）。手术组经放射学证实复发的病例为14.5%(16/110)。这包括4%(3/75)的手术治疗的L-TGCT和37%(13/35)的手术治疗的D-TGCT。表现为疼痛的患者和表现为磁共振成像（MRI）的糜烂性改变的患者更有可能出现持续性术后疼痛（两者均P<0.001）。患者术前既有疼痛又有糜烂改变，57.1%有术后疼痛。13例患者接受了非手术治疗，症状轻微，1例以后需要手术。
■TGCT管理的结果取决于疾病类型，术前糜烂改变的程度，和术前疼痛的存在。这些数据可用于指导患者手术干预的结果，并有助于指导干预的时机。
■三级,回顾性队列研究。
