Giant Cell Tumor of Tendon Sheath at Ankle and Foot ―― Case Series and Literature Review

Background: Giant cell tumor of tendon sheath (GCTTS) is a slow growing soft tissue mass that develops for months to years. It is the second most common tumor of the hand, but is relatively rarely occurred at foot and ankle. The most common treatment is local excision. Aim and Objectives: To figure out the clinical characteristics of GCTTS at foot and ankle, local recurrent rate of GCTTS, and outcome. Materials and Methods: We presented fourteen patients with giant cell tumor of tendon sheath located at foot and ankle in a single institute between January 2006 to September 2016 with a retrospective method. All patients underwent complete local excision. Results: The male-to-female ratio was 6:8 (43%:57%). Their ages were between 8 to 61 years old (mean age: 38 years old). Follow up periods ranged from 6 months to 10 years (mean: 4.8 years). Only two patient had local recurrence after two and seven years. Local recurrent rate was 14 % (2/14). The morbidity was minimal. Conclusion: The way to reduce local recurrent rate of giant cell tumor is complete local excision. MRI can play a role in differential diagnosis and identification of invasion depth.

關鍵字

giant cell tumor of tendon sheath (GCTTS) ； local excision ； MRI ； local recurrent rate

並列摘要

背景：腱鞘巨大細胞瘤是種緩慢成長的腫瘤。它是手部常見腫瘤的第二名，但卻非常少見於足與腳踝。最常見的治療方式為局部切除。但依以往文獻，手部腱鞘巨大細胞瘤局部性復發的機率很高。為了避免復發，完全且仔細的切除以目可視的腫瘤非常重要。我們分析在永康奇美醫院位於足與腳踝的腱鞘巨大細胞瘤案例。這是目前台灣唯一一篇針對足與腳踝的腱鞘巨大細胞瘤做的病例分析。目的及目標：為了瞭解在足與腳踝的腱鞘巨大細胞瘤好發的位置、年齡層、性別分布、手術前的評估、之後的復發率與預後，及有無復發的危險因子。材料及方法：回溯性分析從2006年至2016年在永康奇美醫院位於足與腳踝的腱鞘巨大細胞瘤案例，追蹤年限從半年至十年。我們收集了年齡、性別、位置、手術前評估、復發率及其他臨床相關表徵。結果：總共有14個病人，所有病人都接受了局部切除。有兩個病人有復發的情況。手術前評估大部分為X-ray，有三位病人因為腫瘤體積相對大而且無法預測侵犯的深度所以有接受MRI的評估。結論：跟手部相比，在足與腳踝的腱鞘巨大細胞瘤相對起來非常罕見。在我們醫院，所有四肢的腱鞘巨大細胞瘤產生在足與腳踝的比例只有19%。我們手術後局部復發率為14%。術後併發症少。能降低局部復發率的方法惟有完整且仔細的切除手術。MRI在鑑別診斷與評估腫瘤侵犯深度上扮演重要的角色。

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Giant Cell Tumor of Tendon Sheath at Ankle and Foot ―― Case Series and Literature Review

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