title: Giant cell tumours of tendon sheath of hand: causes and strategies to prevent recurrence.
abstract: Giant cell tumours of tendon sheath of hand present a surgical dilemma due to their high incidence of local recurrence. We present a case series of 46 patients with 47 histologically confirmed giant cell tumours of tendon sheath over a ten-year period from 1998 to 2008. The mean follow-up was 47 months (range 25-124 months). We identified tumours with bony erosions and piecemeal resections as predictors of recurrence. Our recurrence rate of 9% was at the lower end of spectrum of previously published reports (range 7%-44%). We recommend "en-masse" excision of these tumours. All the patients with suspicion of these tumours should have preoperative radiographs to identify erosions. A thorough curettage of the bone should be done in cases with osseous erosion to prevent recurrence. Patients with these risk factors should be followed up annually for five years and be warned about recurrence.
authors.affiliation: Queen Mary's Hospital Sidcup, South London Healthcare NHS Trust Sidcup, Kent, DA14 6LT, UK. azal4u@doctors.net.uk
authors.forename: Azal
authors.initials: A
authors.lastname: Jalgaonkar
authors.forename: Baljinder
authors.initials: B
authors.lastname: Dhinsa
authors.forename: Howard
authors.initials: H
authors.lastname: Cottam
authors.forename: Ganapathyraman
authors.initials: G
authors.lastname: Mani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005870:Giant Cell Tumors / Q000175:diagnosis / Q000601:surgery*; D006225:Hand / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012983:Soft Tissue Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013710:Tendons / Q000601:surgery*; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult