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KMID : 0613320030090010052
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Journal of the Korean Bone and Joint Tumor Soceity
2003 Volume.9 No. 1 p.52 ~ p.60
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Giant Cell Tumor of Tendon Sheath in Hand ; Comparative Studies Between Single and Multifocal Lesions
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Rhee Seung-Koo
Kang Yong-Koo
Park Won-Jong
Yang Sung-Cheol
Shin Yun-hack
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Abstract
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Purpose : To analyse their end results and also to differentiate the single or multiple giant cell tumor(GCT) of tendon sheath in hand.
Materials & Methods : Total 21 cases with GCT of tendon sheath in hand were treated surgically and analyzed their end results with clinically, radiologically and pathologically to allowed for average 16 months after surgical excision.
Results : The finger flexor tendons, especially on index and ring finger, involving diatal interphalangeal joint and mid-phalanges in fourth decades(average age of 47 years old) were frequently involved, and the mass was not exceed than 2 cm in size, fixed on tendon sheath with rubbery hard tenderness but rare bony involvements except 4 cases of bony erosion and cortical perforation. The three cases with multiple GCT of hand was also combined with familial hypercholesterolemia, and are commonly involved the extensor tendons as well as achilles tendons bilaterally, treated with partial excision because of multiplicity. Average 16 months after surgical excision for single GCT cases was followed and showed the recurrence in 3 cases(3/18 16.7%), treated with wide excision. The single and multifocal GCT are similar in pathologic changes but different soft tissue tumors in their pathogenesis, treatment and prognosis.
Conclusion : Incomplete excision of GCT of tendon sheath in hand are thought to be the cause of recurrence, especially in cases with incomplete lesional excision, in multilobular and bony involvement etc. So careful wide excision is necessary to prevent the recurrence.
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KEYWORD
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Hand, Giant cell tumor, Tendon sheath, Hypercholesterolemia
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