Extra-Articular Diffuse Giant Cell Tumor of the Tendon Sheath: A Report of 2 Cases

Document Type : CASE REPORT


The First Department of Orthopaedic Surgery, University of Athens School of Medicine, “ATTIKON” Hospital, Athens, Greece


Two rare cases of extra-articular diffuse variant giant cell tumor of the tendon sheath are presented, at the elbow of a 68-year-old female and the foot of a 56-year-old male. Both patients presented with a palpable masses and marginal excision was performed; histological sections confirmed the diagnosis of extra-articular giant cell tumor. No adjuvant therapy was administered. At the last follow-up, minimum 24 months after excision both patients were disease-free.


1. Somerhausen NS, Fletcher CD. Diffuse-type giant cell
tumor: clinicopathologic and immunohistochemical
analysis of 50 cases with extraarticular disease. Am J
SurgPathol. 2000; 24(4):479–92.
2. Ferrer J, Namiq A, Carda C, López-Ginés C, Tawfik O,
Llombart-Bosch A. Diffuse type of giant-cell tumor of
tendon sheath: an ultrastructural study of two cases
with cytogenetic support. Ultrastruct Pathol. 2002;
3. De Benedittis M, Turco M, Petruzzi M, Cortelazzi R.
Extra-articular diffuse-type giant cell tumour of the
temporomandibular joint. Int J Oral Maxillofac Surg.
2013; 42(3):380–5.
4. Simon SL, Inneh IA, Lee MS, Sullivan S, Ennis F.
Tenosynovial giant cell tumor of the thigh: positron
emission tomography findings. Am J Orthop. 2011;
5. Masuzawa N, Kishimoto M, Houshimaru M.
Extraarticular paravertebral diffuse-type giant cell
tumor. Skeletal Radiol. 2007; 36(4):321–5.
6. Gong ZC, Lin ZQ, Moming A, Ling B, Liu H, Hu M, et
al. Extra-articular diffuse tenosynovial giant cell
tumour of the infratemporal fossa: report of a case
and literature review. Int J Oral Maxillofac Surg.
2010; 39(8):820–4.
7. Mankin H, Trahan C, Hornicek F. Pigmented
villonodular synovitis of joints. J Surg Oncol. 2011;
8. Flandry FC, Hughston JC, Jacobson KE, Barrack RL,
McCann SB, Kurtz DM. Surgical treatment of diffuse
pigmented villonodular synovitis of the knee. Clin
Orthop Relat Res. 1994; 300(2):183–92.
9. Wan JM, Magarelli N, Peh WC, Guglielmi G, Shek TW.
Imaging of giant cell tumour of the tendon sheath.
Radiol Med. 2010; 115(1):141–51.
10. Abdul-Karim FW, el-Naggar AK, Joyce MJ, Makley JT,
Carter JR. Diffuse and localized tenosynovial giant
cell tumor and pigmented villonodular synovitis: a
clinicopathologic and flow cytometric DNA analysis.
Hum Pathol. 1992; 23(7):729–35.
11. Enzinger W. Benign fibrohistiocytic tumors. In:
Enzinger W, editors. Soft tissue tumors. 3rd ed. St.
Louis: Mosby; 1995. p. 293–323.
12. Van der Heijden L, Gibbons CL, Dijkstra PD, Kroep
JR, van Rijswijk CS, Nout RA, et al. The management
of diffuse-type giant cell tumour (pigmented
villonodular synovitis) and giant cell tumour of
tendon sheath (nodular tenosynovitis). J Bone Joint
Surg Br. 2012; 94(7):882–8.
13. Murphey MD, Rhee JH, Lewis RB, Fanburg-Smith JC,
Flemming DJ, Walker EA. Pigmented villonodular
synovitis: radiologic-pathologic correlation.
Radiographics. 2008; 28(5):1493–518.
14. Middleton WD, Patel V, Teefey SA, Boyer MI. Giant cell
tumors of the tendon sheath: analysis of sonographic
findings. AJR Am J Roentgenol. 2004; 183(2):337–9.
15. Sanghvi DA, Purandare NC, Jambhekar NA, Agarwal
MG, Agarwal A. Diffuse-type giant cell tumor of
the subcutaneous thigh. Skeletal Radiol. 2007;
16. Kuhnen C, Müller KM, Rabstein S, Kasprzynski A,
Herter P. [Tenosynovial giant cell tumor]. Pathologe.
2005; 26(2):96–110.