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 language | English (US) |
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Pages (from-to) | 583.e19-583.e24 |
Journal | World neurosurgery |
Volume | 92 |
DOIs | |
State | Published - Aug 1 2016 |
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