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Objective: To compare the MRI findings between the localized- and diffuse-type tenosynovial giant cell tumors (TSGCTs) of digits with pathology correlation. Methods: Twenty-eight patients with newly diagnosed TSGCTs of digits (22 localized and 6 diffuse types) who underwent preoperative MRI and surgical excision were included from Jan. 2015 to September 2021. MRI findings regarding nodularity, margins, morphology of hypointensity with pathology correlation, and disease extent (bone erosion, articular involvement, muscle involvement, tendon destruction, and neurovascular encasement) were assessed. Results: Diffuse type was significantly larger (P = 0.006), more multinodular on both MRI and pathology (P = 0.038, both) with significant agreement, and infiltrative on both MRI and pathology (P < 0.001, both) with substantial agreement, and showed central granular on MRI and strong hemosiderin deposition on pathology (P = 0.022 and P = 0.021) with moderate agreement than localized type. Localized type showed significantly more frequent peripheral capsules on both MRI and pathology (P < 0.001, both) with moderate agreement than diffuse type. However, the septum on both MRI and pathology showed no statistically significant difference between the two groups (P = 0.529 and P = 0.372) without significant agreement. The disease extent was more severe in the diffuse type than the localized type regarding articular involvement (P < 0.001), muscle involvement (P < 0.001), and tendon destruction (P = 0.010). No statistically significant differences were found between the two groups regarding bone erosion (P = 0.196) or neurovascular bundle encasement (P = 0.165). Conclusions: Diffuse-type TSGCTs of digits presented as locally aggressive lesions with larger, multinodular, infiltrative masses exhibiting stronger hemosiderin deposition and more severe disease extents of articular, muscle, and tendon involvement than the localized type. [ABSTRACT FROM AUTHOR]

Objectives: To review the clinical and imaging data of spinal giant cell tumour of the tendon sheath (GCTTS) to improve our understanding of the disease. Methods: The imaging findings, clinicopathological features and clinical outcomes of 14 patients with pathologically confirmed spinal GCTTS were analysed retrospectively. Results: All 14 patients had a single spinal lesion, including ten cervical vertebra lesions and four thoracic vertebra lesions. CT scan findings: The lesions showed osteolytic bone destruction and were centred on the facet joint, eroding the surrounding bone with a paravertebral soft tissue mass. MRI scan findings: all the lesions manifested predominantly as isointense or hypointense on T1-weighted imaging (T1WI). On T2-weighted imaging (T2WI), eight lesions were hypointense, and four were isointense. The remaining two lesions showed slight hyperintensity. The enhanced scans of eight lesions showed moderate to marked homogeneous or heterogeneous enhancement. PET/CT findings: Among the five patients who underwent PET/CT, three presented lesions with well-defined, sclerotic borders, and the uptake of 18F-FDG was markedly increased. One lesion showed an ill-defined border and an uneven increase in 18F-FDG uptake with an SUVmax value of 8.9. A recurrent lesion was only found on PET/CT 45 months after surgery and the SUVmax was 5.1. Conclusions: Spinal GCTTS is extremely rare. Osteolytic bone destruction in the area of the facet joint with a soft tissue mass and hypointensity on T2WI images are indicative of the spinal GCTTS. GCTTS shows high uptake of 18F-FDG, and PET/CT is helpful in detecting recurrent lesions. [ABSTRACT FROM AUTHOR]

Introduction: Tenosynovial giant-cell tumor also known as pigmented villonodular synovitis (PVS) is a benign but aggressive synovial proliferative disease most often affecting the knee joint. The mainstay of therapy is surgical resection. Due to a high rate of local recurrence, radiosynoviorthesis (RSO) is used as an adjuvant method in many cases. The aim of this study was to compare local recurrence (LR) rates after surgical synovectomy with and without adjuvant RSO.Materials and Methods: From 1996 to 2014, 37 surgical interventions were performed in 32 patients with diffuse pigmented villonodular synovitis of the knee. All patients underwent open synovectomy. Adjuvant radiosynoviorthesis (RSO) was applied in 26 cases, the control group consists of 11 cases without RSO.Results: 9 (24%) lesions recurred within a median of 19 months after surgery. Of those 9 recurrences, 3 (17%) were seen in primary disease, 6 (32%) in already recurring cases (n.s.). In 26 RSO treated patients 6 (23%) recurred, in 11 patients of the control group, 3 (27%) recurred (n.s.).Conclusions: RSO is effective in PVS as also shown in some smaller reports in the literature. But surgery is still the mainstay of therapy. RSO is not a method of compensating for an insufficient surgical approach, but it may reduce the high rate of LR in patients with large and even recurrent diffuse forms of the disease. [ABSTRACT FROM AUTHOR]

Giant cell tumor of tendon sheath (GCTTS) is the second most common benign tumor of the hand. Simple excision is the treatment of choice if any related discomfort occurs. Based on the most widely accepted hypothesis, GCTTS is a reactive or regenerative hyperplasia associated with an inflammatory process. However, it still can cause cortical erosion and recur at times. This study proposes to evaluate the clinical features and therapeutic opinions of the tumor and identify the probable recurrence risks. From January 2008 to December 2013, 23 patients with GCTTS of the hand had surgical interventions at our institute. Plain X-rays and magnetic resonance image (MRI) were performed before surgeries. The tumors were removed by marginal or intralesional excision according to their morphology. One patient had accompanied cortical erosion was treated with thorough bone curettage and graft with artificial bone substitutes in addition to tumor excision. Seven patients had transient finger paresthesia after operation and got remission within 3 months. Three had permanent finger paresthesia but improved after medications. No vascular injury or limited motion was noted. During the average follow-up period of 28.5 months (24~35), 3 patients with multi-lobulated tumors had recurrence requiring re-exploration. Surgical excision provides good outcomes of treating the symptomatic GCTTS. Tumor morphology could be a risk factor for recurrence. Higher recurrence rate is associated with not only the type II tumors but also the type I tumors with multi-lobulated pattern. [ABSTRACT FROM AUTHOR]

Malignant pigmented villonodular synovitis is an extremely rare and controversial disease. We describe malignant change in pigmented villonodular synovitis of the ankle in a patient with an unusually long clinical history. Symptoms began at age 21, metastatic disease developed at age 85, and the patient died 1 year later. The histologic appearance of the malignant tumor differed from that in most reported cases, in that spindle-shaped cells predominated. Lymph node metastasis also developed, a feature uncommon to soft tissue sarcomas. [ABSTRACT FROM AUTHOR]

Giant cell tumor of tendon sheath is the second most common tumor of the hand. It can also occur in larger joints. Radiologic features include a soft-tissue mass with or without osseous erosion. Less commonly, it can cause periostitis or permeative osseous invasion; it may rarely calcify. The entire imaging spectrum of this lesion is presented, with emphasis on atypical appearances which can mimic other lesions. [ABSTRACT FROM AUTHOR]

Giant cell tumor of tendon sheath (GCTTS) and Wegener’s granulomatosis (WG) are rare conditions both characterized by polyclonal cellular proliferation and multinucleated giant cells formation. Here, we report the case of a 27-year-old Caucasian woman affected by WG who experienced the metachrone appearance of two different GCTTSs at the right hand within a time of 3 years. To our knowledge, the combination of GCTT with WG is exceptional and this could probably be the first case reported. The subsequent appearance of two rare diseases both characterized by giant cell formation apparently points to similarities in their pathogenesis. However, at present no pathogenic relationship between GCTTS and WG is demonstrable and their simultaneous occurrence has to be considered coincidental. Actually, an emerging opinion is to consider GCTTS as a mixed lesion in which both tumoral and non-tumoral inflammatory cells play a central pathogenic action. On this view, the proposed case could support the evidence about the crucial role of a chronic inflammatory injury in enhancing GCTTS appearance. [ABSTRACT FROM AUTHOR]