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      Hot shoulder PET/CT lesion: Unusual presentation of tenosynovial giant cell tumor

      case-report
      Author(s): , MD * , , MD, , MD
      Publication date (Electronic):
      Journal: Radiology Case Reports
      Publisher: Elsevier
      Keywords: PET, Shoulder, Tenosynovial giant cell tumor

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          Abstract

          We present a case of a tenosynovial giant cell tumor (TGCT) incidentally discovered at the shoulder on PET/CT, in a patient with history of thyroid cancer. Many documented cases of TGCT have been incidentally imaged by PET/CT and have been found to have varying levels of metabolic activity, however the shoulder location is unusual. This type of musculoskeletal lesion often has MRI characteristics, such as gradient echo blooming, which can render a confident diagnosis without need for biopsy.

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          Giant cell tumor of tendon sheath: case series and review of literature.

          S. Suresh, Hosam Zaki (2010)
          Recurrence of Giant cell tumor of the tendon sheath (GCTTS) is an unresolved issue, though it is a non malignant condition. The authors operated on fourteen cases of GCTTS, after fine needle aspiration cytology confirmation and using a magnifying loupe for complete excision of the lesion including the satellite nodules. In only one case recurrence was noted which was successfully managed by a second wide excision. Preoperative diagnosis and meticulous surgical technique were found the only predictive factor of recurrence. During the 5 year period from 2002, 12 patients [11 females, 1 male, mean age 29.5, ranging from 10-53 years] underwent excision of giant cell tumor of tendon sheath of the hand. The lesions were found over the thumb [n = 7], ring finger [n = 1], index finger [n = 1], and over the hand [n = 2]. The lesions were classified using the Al-Qattan classification. The most common presentation was with a mass over the hand, with a predilection to the thumb [n = 7]. Radiological changes in the form of bony indentation was seen in only 2 cases. FNAC was inconclusive in 2 out of the 12 cases. Due to the high incidence of recurrence, pre-operative planning aided by a tissue diagnosis with fine needle aspiration cytology, wide surgical exposure, and meticulous dissection with help of magnification are imperative for a successful outcome in GCTTS.
          Article 0 comments Cited 17 times – based on 0 reviews     Review now
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            Giant Cell Tumor of the Tendon Sheath: Experience With 65 Cases

            Erin L. Adams, Eric Yoder, Morton L. Kasdan (2012)
            Objective: No consensus exists on the etiology, prognostic factors, or recurrence rate of giant cell tumors of the tendon sheath. This article presents a series of 65 cases supplemented by a literature review that examines the epidemiology, presentation, gross and microscopic characteristics, and recurrence rate of giant cell tumor of the tendon sheath. Methods: The authors completed a retrospective review of one surgeon's practice from 1976 to 2001, evaluating 65 cases of giant cell tumor of the tendon sheath. The authors conducted a literature search and compared the case series with historical data. Results: The tumor most commonly presented as a firm, nontender mass in the dominant hand. Our cases showed a slight female predominance of 54%, compared with the literature average of 64%. A pseudocapsule was present in 51% of cases. Overall recurrence rate was 10%. No association was noted between recurrence and pseudocapsule presence, rheumatoid arthritis, or osteoarthritis. Satellite lesions at the first excision were noted in 80% of recurrent cases; however, satellite lesions were not a risk factor for recurrence per se. Conclusions: Our study shows similar findings to the literature, with the notable addition of satellite lesions in recurrent tumors. Marginal excision is the treatment of choice, but may be complicated when the tumor is attached to vital structures. Therefore, an appropriate balance between resection of tumor and maintenance of function must be achieved due to the possibility of recurrence.
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              Giant cell tumor of tendon sheath: study of 64 cases and review of literature.

              S Di Grazia, G Succi, F Fragetta … (2016)
              The giant cell tumor of tendon sheath (GCTTS) is the most common benign neoplasm in the hand after the ganglion cyst. Several hypotheses were formulated about the etiological factors of these tumors, but still there is not a common opinion on etiology, prognostic factors and recurrence rate. This article presents a review of literature of the last 15 years about GCTTS to assess the demographic, clinical and histological profile. We compared the information obtained from literature with our experience of 64 cases between 2000 and 2012. Our study showed similar results to those reported in literature, except for the recurrence rate: only 3 cases (4.7%) of 64 patients reported recurrence (versus about 15% on average in literature). Among the various possible factors that predispose to recurrence, it is necessary that the surgeon ensures complete excision of the tumor and removal of any residual satellite nodules. Although the marginal excision is the treatment of choice, it is often difficult to perform due to for the location and the strict adherence of the tumor to the tendon or neurovascular bundles. We used in all cases a magnifying loupe to help a careful research of satellite lesions and to respect surrounding structures.
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                Author and article information

                Contributors
                Steven Lewis
                Journal
                Journal ID (nlm-ta): Radiol Case Rep
                Journal ID (iso-abbrev): Radiol Case Rep
                Title: Radiology Case Reports
                Publisher: Elsevier
                ISSN (Electronic): 1930-0433
                Publication date PMC-release: 08 March 2018
                Publication date Collection: June 2018
                Publication date (Electronic): 08 March 2018
                Volume: 13
                Issue: 3
                Pages: 559-562
                Affiliations
                Department of Radiology, David Grant Medical Center, Travis AFB, CA, USA
                Author notes
                [* ]Corresponding author. steven.lewis7@ 123456gmail.com
                Article
                Publisher ID: S1930-0433(17)30539-3
                DOI: 10.1016/j.radcr.2018.02.006
                PMC ID: 6030548
                SO-VID: d0f71e4f-02c2-465d-89ca-c24af8fb99c6
                Copyright © © 2018 the Authors. Published by Elsevier Inc. under copyright license from the University of Washington.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 15 December 2017
                Date accepted : 3 February 2018
                Categories
                Subject: Musculoskeletal

                Keywords: pet,shoulder,tenosynovial giant cell tumor
                Data availability:
                Keywords: pet, shoulder, tenosynovial giant cell tumor

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