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Citation: Souissi M, Arfa W, Jlalia Z, Jenzri M. Tenosynovial giant cell tumor of the foot in a child. Jr. med. res. 2023; 6(2):17-19. Souissi et al © All
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Images in clinical practice
Souissi Meriem
1,2
, Abid Said
1,2
, Arfa Wajdi
*1,2
, Jlalia Zied
1,2**
, Jenzri Mourad
1,2
.
Tenosynovial giant cell tumor of the foot in a child.
1: Department of pediatric orthopedics
Kassab Institute, Tunis, Tunisia
2: College of Medicine, Tunis, Tunisia
* Corresponding author
** Academic Editor
Correspondence to:
arfa.wajdi@gmail.com
Publication Data:
Submitted: May 27,2023
Accepted: June 28,2023
Online: November 30,2023
This article was subject to full peer-
review.
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Tenosynovial Giant Cell Tumor (TGCT) is a rare benign soft tissue tumor arising
from the synovium and peri-articular structures. This tumor is usually diagnosed
in adult age, the hands are the most frequent location. The gold standard for
TCGT treatment is the adequate surgical excision. We herein report a case of a
TGCT of the hallux in a 5-year-old patient.
Keywords
Giant cell tumors ; Child; foot; soft tissue neoplasms.
Introduction
Tenosynovial Giant-cell tumor (TGCT) is a benign solitary tumor arising in the
extremities, more commonly in the flexor tendons of the hands [1]. It usually
affects individuals between the third and fifth decade and is reported incidentally
in children [2]. We present a rare case of a TGCT affecting the hallux extensor
tendon in a 5-year-old patient.
Observation
A 5-year-old girl, with no previous medical history presented to the outpatient
clinic for swelling on the dorsal aspect of her right hallux evolving for two years.
The mass was firm, painless, mobile and the skin was normal (Figure 1).
The mobility of interphalangeal articulation wasn’t affected. No bone lesions were
seen in the standard X-rays.
The MRI revealed well circumscribed mass measuring 16*16*6 mm, encountering
the hallux extensor tendons, with hemosiderin deposit, suggesting a giant cell
tumor (Figure 2). Patient underwent complete surgical resection. Intraoperatively,
the mass was encapsulated and had macroscopic encephaloid aspect. It had an
intimate contact with the tendon sheath and the articulation capsule which were
excised (Figure 3). Histopathological examination revealed giant cell tumor of the
tendon sheath without malignant cells and clear resection margins. Postoperative
course was uneventful, and no recurrence were noted during the follow up.
Comments
TGCT are benign soft tissue lesions of the extremities arising from the synovium,
tendon sheath, bursae and small joint periarticular structures [2,3]. These tumors
are very rare in children. Reported pediatric incidence is up to 4% for both upper
and lower extremities.
Painless slow-growing soft tissue mass is the most frequent clinical presentation
[4,5]. MRI is a gold standard examination for the preoperative diagnosis. Specific
findings of hemosiderin deposit are evocative of TGCT [6]. Complete surgical
excision with sufficient safe margins is the best management option. tyrosine-
kinase inhibitors are indicated for some diffuse or recurrent forms [7].
Significant risk factors for recurrence include radiographic presence of osseous
pressure erosion, incomplete excision, increased cellularity or mitosis, cytogenetic
abnormalities such as trisomy 7 and inhibited expression of nm23 gene [8].
Abstract
Tenosynovial giant cell tumor of the foot in a child
Citation: : Souissi M, Arfa W, Jlalia Z, Jenzri M. Tenosynovial giant cell tumor of the foot in a child. Jr. med. res. 2023; 6(2):17-19. Souissi et al © All
rights are reserved. Submit your manuscript: www.jmedicalresearch.com.
Figure 1: Swelling opposite to the interphalangeal articulation of the right Hallux.
Figure 2: X-rays showed no bone lesions, MRI noted well circumscribed mass measuring 16x16x6 mm, coming in contact
with the hallux extensor tendons, with hemosiderin deposit.
Figure3: macroscopic aspect of Well encapsulated encephaloid mass.
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Tenosynovial giant cell tumor of the foot in a child
Citation: : Souissi M, Arfa W, Jlalia Z, Jenzri M. Tenosynovial giant cell tumor of the foot in a child. Jr. med. res. 2023; 6(2):17-19. Souissi et al © All
rights are reserved. Submit your manuscript: www.jmedicalresearch.com.
Conflict of Interest: None
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