UNASSIGNED: Giant cell tumors of tendon sheath are benign, rarely malignant, soft-tissue tumors arising from tenosynovial sheath and periarticular soft tissue. They usually present as painless masses with some restriction of movement. Histopathological diagnosis is gold standard although pre-operative fine-needle aspiration cytology (FNAC), plain radiographs, and MRI help in narrowing down the differentials. Giant cell tumor of the tendon sheath (GCTTS) although benign is notorious for having a high rate of recurrences, with most important risk factors being adjacency to joint and incomplete excision. Adequate marginal excision forms the mainstay for managing these tumors. Adjuvant radiotherapy has found some role in treating and decreasing the chances of recurrences.
UNASSIGNED: A 55-year-old lady was brought to the outpatient department with a history of painless, gradually progressive swelling on volar aspect of thumb. Swelling was well defined with a smooth surface. Overlying skin showed no signs of local inflammation or adherence. Pain radiographs showed soft-tissue shadow with some articular bony erosions. A ultrasound-guided FNAC and MRI showed a picture of GCTTS. An excisional biopsy was done and confirmed the diagnosis.
UNASSIGNED: GCTTS is a benign entity with a slow course of evolution, although uncommon, and should be kept as differential for swellings of hand and feet. Complete excision with no evidence residual tumor is diagnostic as well as curative. A regular follow-up is essential on account of high rates of recurrences.

Diffuse type tenosynovial giant cell tumour of the temporomandibular joint (D-TGCT-TMJ) is a rare proliferative disorder. The aim of this study was to perform a systematic review of the literature to summarize D-TGCT-TMJ management regimes and recurrence rates with at least 12 months of follow-up. Our secondary aim was to propose a minimum period of post-operative follow-up. A medline search for any D-TGCT-TMJ case detailing treatment, follow-up of at least 12 months, and presence of recurrence was undertaken. The following variables were extracted from the studies: patient\'s age and sex, presence of middle cranial fossa invasion, treatment undertaken, total length of follow-up, and presence of recurrence. All studies were assessed for bias as per the Joanna Briggs Institute systematic reviews appraisal tool. There were 63 cases reviewed and were predominantly managed with total resection (60.3%). Other modalities included: arthroplasty, subtotal resection with or without postoperative radiotherapy, medical therapy and surveillance. The recurrence rate was 9.52% and the longest follow-up period where recurrence was observed was at 60 months. Total resection and arthroplasty are common D-TGCT-TMJ management regimes. Patients with D-TGCT-TMJ should be followed up annually for at least 5 years postoperatively to assess for recurrence.

BACKGROUND: Tenosynovial giant cell tumor (TGCT) is a neoplastic, inflammatory disease with a benign but aggressive course that often presents as localized (TGCT-L) and diffuse (TGCT-D) forms based on the growth pattern and clinical behavior. For TGCT-L, simple excision of the diseased synovial tissue is the preferred treatment option, while for TGCT-D, adequate synovectomy is usually tricky but is essential. However, approximately 44% of TGCT-D cases will relapse after surgery alone. Thus, the optimal treatment strategy in patients with TGCT-D is evolving, and standalone surgical resection can no longer be regarded as the only treatment. The previous studies have shown that postoperative adjuvant radiotherapy can reduce recurrence in TGCT, especially in patients with incomplete synovectomy.
UNASSIGNED: In the first case, a 54-year-old male presented with recurrent pain and swelling of the right knee with a protracted disease course (≥10 years). The other patient is a 64-year-old male who developed swelling, pain, abnormal bending, and limited movement of the left knee without obvious inducement.
UNASSIGNED: Clinical and imaging examinations can provide a definitive diagnosis, and pathology is the gold standard. TGCT-D was confirmed by postoperative pathology. After the operation, the patients underwent an MRI re-examination and showed that the lesions of the knee were not completely resected.
METHODS: Arthroscopic synovectomy was performed on the patients, and postoperative pathology was confirmed as TGCT-D. Because of incomplete synovectomy, the 2 cases received image-guided, intensity-modulated radiotherapy (IG-IMRT) after the operation.
RESULTS: The follow-up time was 1 year, no evidence of disease progression was found in MRI. No obvious adverse effects associated with radiotherapy were detected during the follow-up period.
CONCLUSIONS: These cases and reviews illustrate the necessity of radiotherapy for TGCT-D and that IG-IMRT is a safe and effective method for treating TGCT-D of the knee.

Tenosynovial giant cell tumor is the common term used to describe a group of soft-tissue tumors that share a common etiologic link. These tumors are relatively infrequent in the foot and ankle, and occasionally they may be the cause of destruction of the adjacent bone structures. We report the imaging appearance and pathologic findings of two patients with localized tenosynovial giant cell tumor of the forefoot. Both of these patients underwent surgical gross total resection. However, one of the patients experienced a recurrence. Their clinical, radiologic, and pathologic features, with their treatment protocol, are summarized retrospectively, and related literature is reviewed in an attempt to enhance the understanding of these tumor lesions. Clinicians should perform a careful preoperative and postoperative examination and complete tumor surgical resection with the aim of reducing local recurrence.

A 74-year-old Japanese woman with a 1-year history of right preauricular pain and a 2-month history of bleeding from the right ear was admitted to our department. Tumor was observed in the anterior wall in the right external auditory canal. Bony swelling of the right preauricular area was palpated. Computed tomography revealed an ill-defined, osteogenic tumor around the mandibular condyle with a destructive bony lesion involving the temporal bone. Magnetic resonance imaging revealed a 2.0 × 1.5 × 1.3-cm solid tumor around the mandibular condyle, exhibiting a low-intensity signal on T1-weighted imaging and an isointense central area surrounded by low-signal intensity on T2-weighted imaging. Histological examination of biopsy specimens revealed diffuse-type tenosynovial giant cell tumor (D-TGCT). After the feeding arteries for the tumor were embolized, the patient underwent surgery with combined temporal craniotomy and mandibular condylectomy. The soft and cystic tumor with calcification located in the extradural space was totally resected along with the mandibular condyle. No facial paralysis or recurrence was evident as of 6 months postoperatively. To date, only 23 cases of D-TGCT arising in the temporomandibular joint (TMJ) with ear involvement have been reported since 2011. We report successful resection of a rare case of D-TGCT arising in the TMJ.

The spectrum of diagnoses and clinical features of hand tumors differ from those of tumors in other body parts. However, only a few reports have comprehensively referenced the diagnosis and clinical features of hand tumors. This study aimed to elucidate the diagnostic distribution and the clinical features of hand tumors undergone surgery in our institute.
A total of 235 lesions in 186 patients diagnosed with hand tumors between 1978 and 2020 were reviewed. Age at surgery, gender, chief complaint, tumor location, and pathological diagnosis were analyzed.
There were 121 benign bone tumors, 98 benign soft tissue tumors, and 16 malignant tumors. Chondroma and tenosynovial giant cell tumor were common benign bone and soft tissue tumors at the proximal phalanx of the ring finger and the palm, respectively. Meanwhile, chondrosarcoma and synovial sarcoma were common malignant tumors at the dorsal part of the hand. Local pain and painless mass were the chief complaints in patients with benign bone and soft tissue tumors, respectively. Most patients with malignant tumors were referred after unplanned resection. When patients were classified into two categories by tumor size according to maximal diameter, tumors larger than 19 mm had a significantly higher risk of malignant (p = 0.031) despite being smaller than other tumors in different body parts.
When a tumor malignancy is suspected, the patient should be referred to a specialist to avoid unplanned resection or delayed diagnosis due to misdiagnosis. Knowing the distribution and clinical features should help in diagnosing hand tumors.

Benign and malign tumors can affect the temporomandibular joint (TMJ) as any other articulation. Nevertheless, TMJ tumors are rare and mostly benign. Their clinical expression is varied including symptomatology similar to TMJ dysfunctional disorders, otologic or neurologic pathologies. In some cases, they remain totally asymptomatic. Hence, diagnosis is difficult since the symptomatology can be misleading with TMJ dysfunctional disorders or otologic disorders wrongly diagnosed. There is thus frequently a long delay between symptoms onset and diagnosis. The great variety of TMJ lesions explains the wide range of possible treatment modalities, mostly based on surgery. We provide here a review of the lesions originating from the TMJ. Tumoral or cystic mandibular lesion affecting the TMJ through local extension will not be discussed. Osteoma, osteoid osteoma, osteoblastoma, chondroma, osteochondroma, chondroblastoma, tenosynovial giant cell tumors, giant cell lesions, non-ossifying fibroma, hemangioma, lipoma or Langerhans cell histiocytosis are all possible diagnosis among the benign tumors found in the TMJ. Pseudotumors include synovial chondromatosis and aneurysmal bone cyst. Finally, malign tumors of the TMJ include mainly sarcomas (osteosarcoma, chondrosarcoma, synovial sarcoma, Ewing sarcoma, and fibrosarcoma), but also multiple myeloma and secondary metastases. We will review the clinical, radiological and histological aspects of each of these lesions. The treatment and the recurrence risk will also be discussed.

Tenosynovial giant cell tumor (TSGCT) represents a family of benign tumors that arise from the synovial tissue of a joint, tendon sheath, or bursa. It usually involves the joints of the extremities and rarely occurs in the head and neck region. Here, we describe a case of a 32-year-old man with a submucosal mass bulging in the posterior pharyngeal wall since one month. The lesion was removed and diagnosed with localized type of TSGCT based on histopathological investigations and clinical presentation. It is very rare that TSGCT occurs in the retropharynx, which reminds clinicians to consider this entity as a possible diagnosis.

UNASSIGNED: GCTTS is the second most popular soft tissue tumor at the hand next to ganglion cyst, and also named tenosynovial giant cell tumor or pigmented villonodular tenosynovitis. It is divided into localized form and diffuse form. We introduce a report of a rare case of GCTTS in a female where lesions were identiied within the left ring finger and also conducted a literature review.
UNASSIGNED: We describe a 32-year-old female patient with GCTTS a single digit since six months. Radiographic and histopathological examination is necessary to help determine whether to take further treatment. Surgical excision was performed, including complete removal of the tumor and reconstruction of the pulley with autologous tendon. Histopathology suggested that these masses were consistent with GCTTS without malignancy. There was no clinical and radiologic evidence of recurrence six months after surgery.
UNASSIGNED: GCTTS is a benign fibrous tissue tumor originating from the tenosynosheath, bursae and joint synovium. This tumor is more common in adults aged 30-50, and is slanted toward females. The major risk of GCTTS is recurrence and joint damage, which requires surgical resection. The integrity of the pulley plays an important role in the function of the hand. In this case, the ipsilateral metacarpal tendon was taken during the operation to reconstruct the pulley to reduce the possibility of loss of hand function.
UNASSIGNED: This case represents a rare case of GCTTS at the hand within a single digit. Due to its high recurrence rate, the tumor should be completely removed to reduce the possibility of recurrence. Radiographic and histopathological examination must be performed on the tumor, which is determined to be benign and does not require further treatment. The function of the hand should be reconstructed to minimize the loss if necessary.

OBJECTIVE: The aim of this study was to retrospectively analyze the clinical characteristics, surgical treatment, and prognosis of patients with diffuse-type tenosynovial giant cell tumor (D-TGCT) involving the temporomandibular joint (TMJ) and the skull base.
METHODS: A retrospective study was performed in patients with D-TGCT involving the TMJ and the skull base at our institute from April 2009 to August 2018. Data on clinical characteristics, surgical treatment, and prognosis were collected and analyzed. A literature search on D-TGCT involving the TMJ was conducted and the data analyzed.
RESULTS: The study included 22 patients (14 males and 8 females), with an average age of 44 years. The main symptoms were headache and hearing limitation, accompanied by a swelling in the TMJ area. Magnetic resonance imaging (MRI) showed low signals on T1- and T2-weighted images. All lesions were completely removed. Temporal bone flap, titanium mesh, and temporal muscle flap were used for reconstruction. The recurrence rate was 4.5%. In the literature, 115 cases were reported. Surgery alone was performed in 88 cases; postoperative radiotherapy was performed in 19 cases; the tumor recurrence rates were 9.1% and 15.8% for the 2 procedures, respectively. All patients were alive at the end of the follow-up period.
CONCLUSIONS: D-TGCT involving the TMJ and the skull base is a locally aggressive but benign lesion necessitating complete resection and has a good prognosis.