Nerve-Adherent Giant Cell Tumors of Tendon Sheath: A New Presentation

Mohamed A. Elsherif, Doris E. Wenger, Rachael A. Vaubel, Robert J. Spinner

Research output: Contribution to journalArticle

Abstract

Background Tenosynovial giant cell tumors are a group of slowly growing benign neoplasms of synovial membrane of joints, tendons, and bursae. The localized type or giant cell tumor of tendon sheath (GCTTS) is the extra-articular form of tenosynovial giant cell tumors. We describe two patients with a GCTTS, confirmed histologically at the time of surgical resection, that was adherent to peripheral nerves. Rare GCTTS can cause extrinsic compression of major nerves. Case Descriptions The first patient was a 36-year-old man with a left wrist mass associated with pain and paresthesia in the radial three digits. On ultrasound and magnetic resonance imaging (MRI), the mass appeared arising from the left median nerve with a picture suggestive of an atypical neurogenic tumor; however, the possibility of GCTTS could not be excluded. Intraoperatively, the tumor was adherent to the median nerve without a connection to nearby intercarpal joints. The second patient was a 25-year-old woman with a history of malignant melanoma and an incidentally discovered mass on routine follow-up. MRI of the pelvis showed an ovoid mass related to the right sciatic nerve. The MRI picture was suggestive of a GCTTS, although a benign neurogenic tumor was favored given the anatomic relation to the sciatic nerve. Intraoperatively, the tumor appeared as a nodule implanted on the nerve, and it was easily peeled off. Conclusion We present a new, rare presentation of GCTTS adherent to peripheral nerves with extrinsic compression. We suggest either an implantation mechanism or an unrecognized extrasynovial origin for such tumors.

Original languageEnglish (US)
Pages (from-to)583.e19-583.e24
JournalWorld Neurosurgery
Volume92
DOIs
StatePublished - Aug 1 2016

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Keywords

  • Adherent
  • Extrasynovial
  • Giant cell tumor of tendon sheath
  • Implantation
  • Nerve compression
  • Peripheral nerves
  • Tenosynovial giant cell tumors

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Elsherif, M. A., Wenger, D. E., Vaubel, R. A., & Spinner, R. J. (2016). Nerve-Adherent Giant Cell Tumors of Tendon Sheath: A New Presentation. World Neurosurgery, 92, 583.e19-583.e24. https://doi.org/10.1016/j.wneu.2016.05.062