title: [Diagnosis and surgical treatment of giant cell tumor in hand bone].
abstract: OBJECTIVE
  To review the experience with clinical and imaging characteristics of giant cell tumor (GCT) of the hand as well as the surgical outcomes.
  
  
  METHODS
  Between 2000 and 2010,16 cases of GCT of the hand were admitted to our department. There were 10 male and 6 female patients with a  mean age of 41.3 years (age range: 24 to 65 years) with Campanacci's grade I ( n = 0), Grade II (n=12), and Grade III (n=4). Eight cases occurred in  metacarpal bone and 8 cases in phalanx. All patients had the symptoms of pain,swelling and restricted range of motion in the affected joint.The average  time from the onset of the symptom to the first visit of the patients was 12 months( range: 5 to 15 months).Radiographic changes showed osteolytic lesions  occupying at least half of the diaphyseal region in most of the cases. Four grade III patients underwent tumor resection and bone graft or serial amputation,  while 12 Grade II patients extensive curettage and bone graft.
  
  
  RESULTS
  Twelve patients'clinical and radiographic diagnosis at admission was  endochondroma, while postoperative histopathology reported all the lesions as GCT. Twelve patients were followed up for a mean of 58.8 months (range: 24 to 140 months). Immediate relief of pain was observed postoperatively in all patients. No complications, such as infection or joint stiffness, were  observed in any patient. The average healing time of bone graft was 3.3 months (range: 3 to 5 months).Ten gradeII patients were followed up for at least 2  years and 3 of them had local recurrence 8 to 16 months after first resection. En bloc resection was then performed, and no second reccurence was  reported. Two gradeII patients were followed up for at least 2 years and none of them had local recurrence. No malignancy, multiple center lesion or lung  metastasis was reported. Active range of motion in the patients without joint arthrodesis was maintained during the follow-up period.
  
  
  CONCLUSIONS
  GCTs  of the hand are relatively rare, and tend to be misdiagnosed as endochondroma. The results of the present study suggest that extensive curettage  provides favorable local control and satisfactory functional outcomes.
authors.affiliation: Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Guo
authors.forename: Chun
authors.initials: C
authors.lastname: Li
authors.forename: Guang-lei
authors.initials: GL
authors.lastname: Tian
authors.forename: Bao-guo
authors.initials: BG
authors.lastname: Jiang
authors.forename: Jun-hui
authors.initials: JH
authors.lastname: Zhao
authors.forename: Wen
authors.initials: W
authors.lastname: Tian
authors.forename: Shan-lin
authors.initials: SL
authors.lastname: Chen
authors.forename: Hai-hua
authors.initials: HH
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D050278:Finger Phalanges / Q000601:surgery; D018212:Giant Cell Tumor of Bone / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D008297:Male; D050279:Metacarpal Bones / Q000601:surgery*; D008875:Middle Aged