Giant Cell Tumours of Hand Bones: a Report of Two Cases

En bloc resection and iliac crest bone grafting for giant cell tumor of the finger

A case of a rapidly progressing giant cell tumor of the middle phalanx is presented. The patient underwent en bloc resection with iliac crest grafting and distal interphalangeal fusion. Surgical technique and patient's functional outcomes are described.

Benign Hand Tumors (Part I): Cartilaginous and Bone Tumors

Background: Benign tumors of the hand present in a wide array of histological subtypes and compose most of the bony tissue tumors in the hand. This study evaluates the characteristics and treatment of benign bone tumors in light of one institution's experience. Methods: Histologically confirmed benign tumors of the hand were retrospectively identified using International Classification of Diseases codes from 1992 to 2015. A medical chart review was conducted to collect patient characteristics and tumor epidemiology and treatment. Results: A total of 155 benign bone tumors were identified. The median age of patients at the time of surgery was 39.9 ± 12.8 years. All bone tumors were located in the digits, and most were treated by intralesional curettage (n = 118, 76%). Pathologic fractures occurred in 79 bone tumors (51%). Conclusion: Enchondromas (n = 118, 76%) were the most common bone tumor in this series, whereas giant cell tumors were the most destructive and also had the highest recurrence rate (40%). Awareness of tumor features may help physicians with diagnosis, and awareness of recurrence rates is important when counseling patients.

Double central ray amputation of the third and fourth digits for recurrent giant cell tumors of the hand: A case report

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Recurrent giant cell tumor of bone of hand treated by double central ray amputation.

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Double central ray amputation results in acceptable functional outcome of the hand.

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Double ray amputation aims to decrease re-recurrence rates of recurrent GCT of hand.

Introduction and importance

Recurrent giant cell tumor of the bone (GCTB) of the hand is very rare to be encountered. Our aim is to alert the surgeons to such condition and double central ray amputation of the third and fourth digits could be an option which may reduce the chance of a re-recurrence and provide an acceptable functional outcome.

Case presentation

We presented a 25-year-old woman with a recurrent GCTB of the proximal phalanx of the middle finger of the right hand. Considering the recurrent case, a high suspicion of malignancy, and apparent soft tissue extension, the lesion was treated with double central ray amputation of the third and fourth digits through metacarpals.

Clinical discussion

Extraosseous soft tissue invasion of recurrent GCTB of the hand had an important role in the treatment recommendation. A balance must be considered between the risk of re-recurrence and the impact of radical resection on function. Double central ray amputation surgery was performed in order to decrease the risk of additional recurrences. Acceptable functionality of the hand as she scored 26/30 (86 % rating) evaluated by Musculoskeletal Tumor Society (MSTS) Scoring System and no signs of local re-recurrence were found for 6 months follow up.

Conclusion

Double central ray amputation of the third and fourth digits is a good option for management of recurrent GCTB of proximal phalanx of the third digits with gross soft tissue extension to adjacent fourth digits region.

Giant cell tumor of the bone presenting as swelling of the thumb

We describe a giant cell tumor in a 74-year-old man who presented with pain and swelling in the left thumb. Radiographs of the left hand showed some lytic changes at the tip of the thumb. Magnetic resonance imaging suggested the diagnosis of giant cell tumor, which was later confirmed by biopsy. A good treatment response was achieved with disarticulation of the interphalangeal joint and amputation of the distal phalanx of the left thumb.

Reconstruction of hand in aggressive benign bone tumors by mini JESS fixator

We present two cases of young females with aggressive benign bone tumors of the bone (Enchondroma and Giant Cell Tumor). Giant cell tumors and Enchondromas in hand are commonly found benign tumors, which may be locally aggressive. The primary treatment of these lesions is surgical. The two reported cases were treated successfully by extended curettage, bone grafting, and spanning JESS fixator. There was no recurrence in either case at one year follow-up and good hand function and complete healing of the lesion.