PDF(Pubmed)
Abstract：
Here, we report the case of recurrent swelling and pain in the proximal interphalangeal joint of the left ring finger, which was later diagnosed as a localized tenosynovial giant cell tumor in a young adult female. The first presentation was at the same anatomical site four years prior. Examination at presentation showed a firm skin-colored nodule in the volar aspect of the left ring finger. The swelling was seen to be partly attached to underlying structures and was non-tender. After a careful physical examination and plain radiograph imaging of the hand, the two differential diagnoses considered were tenosynovial giant cell tumor and ganglion cyst. A surgical excision was performed, and histopathologic evaluation showed features consistent with a tenosynovial giant cell tumor, localized type. The resection margins were clear of tumor. The patient had no intraoperative or postoperative complications. Postoperative physiotherapy was recommended. No recurrence was seen after postoperative surgical follow-up for one year. This report highlights the importance of histopathologic evaluation and confirmation of clear surgical margins in the management of tenosynovial giant cell tumors. In recurrent cases, surgical re-excision with clear margins provides good clinical outcomes. Before surgical excision, patients should be informed about the biologic nature of the lesion and the high risk of recurrence. The management modalities to prevent recurrence and the need for long-term follow-up should also be discussed with the patient.
摘要：
这里,我们报告了左无名指近端指间关节反复肿胀和疼痛的情况，后来被诊断为一名年轻成年女性的局部腱鞘巨细胞瘤。第一次出现是在四年前的同一解剖部位。演示时的检查显示，左无名指的掌侧有一个坚硬的肤色结节。可以看出，肿胀部分附着在下面的结构上，并且没有触痛。经过仔细的体格检查和手部的X光片成像，两种鉴别诊断为腱鞘膜巨细胞瘤和神经节囊肿。进行了手术切除，组织病理学评估显示与腱鞘膜巨细胞瘤一致的特征，本地化类型。切除边缘明确肿瘤。患者无术中或术后并发症。建议术后物理治疗。术后随访1年无复发。该报告强调了组织病理学评估和明确手术切缘确认在腱鞘膜巨细胞瘤治疗中的重要性。在复发病例中,切缘清晰的手术再切除可提供良好的临床结果.手术切除前,应告知患者病变的生物学性质和高复发风险.还应与患者讨论预防复发的管理方式以及长期随访的必要性。
