title: Nodular giant cell tumour of the tendon sheath of the hand: analysis of eighty-four cases: diagnostic decisions and outcome.
abstract: BACKGROUND
  The giant cell tumour of the tendon sheath (GCTTS) of the hand is a benign tumour of unknown origin. The clinical diagnosis is supported by preoperative imaging. But the ideal imaging methods necessary for the diagnosis, preoperative planning and total tumour resection are still debated. Standard treatment is surgical resection with histological confirmation.
  
  
  METHODS
  We followed up 84 patients who were operated upon for a histologically confirmed nodular type GCTTS for an average of 4.7 years (range four to eight). The preoperative symptoms and radiological findings of X-ray, ultrasound and MRI were reviewed and the surgeon asked for their impact on the surgical procedure.
  
  
  RESULTS
  The average age at operation was 50.9 years, 65.5% of the patients were female and 61.9% of the lesions were located on the palmar aspect. Most tumours were found on the first three fingers. Two patients had tumours at two separate sites (2.4%). After an average follow up of 31.5 months two recurrences were observed (2.4%). In addition to X-ray and ultrasound, the preoperative findings of the MRI had no influence on the surgical procedure.
  
  
  CONCLUSIONS
  Our data on the nodular GCTTS are in accordance with published data concerning the age distribution, gender distribution, and localisation. No soft-tissue imaging method is superior for the diagnosis of nodular GCTTS or for the preoperative planning. A preoperative MRI may not be necessary as clinical and ultrasound examination are sufficient. To exclude bony erosions, a preoperative X-ray is necessary.
authors.affiliation: Department for the Upper Extremity, Hand-, and Microsurgery, Immanuel Hospital, Königstr. 63, 14109, Berlin, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Lautenbach
authors.forename: Simon
authors.initials: S
authors.lastname: Kim
authors.forename: Michael
authors.initials: M
authors.lastname: Millrose
authors.forename: Andreas
authors.initials: A
authors.lastname: Eisenschenk
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005870:Giant Cell Tumors / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D006225:Hand / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D015995:Prevalence; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D012737:Sex Factors; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D013710:Tendons / Q000000981:diagnostic imaging / Q000473:pathology; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult