Giant Cell Tumour of the Tendon Sheath of the Hand: A Retrospective Review With Recurrence Risk Analysis.

INTRODUCTION

Giant cell tumours of the tendon sheath (GCT-TS) are a benign but potentially recurrent soft tissue tumour of the hand. It typically presents as a slow-growing, painless mass and is most frequently located on the volar aspect of the fingers. Despite its benign nature, recurrence rates vary widely across published series.

METHODS

This retrospective study analysed 90 histologically confirmed cases of GCT-TS treated surgically between 2011 and 2023 in a single orthopaedic surgery department. Demographic, clinical, imaging, and histological data were collected. A phone survey was conducted to assess long-term outcomes and possible recurrence. In cases of suspected recurrence, in-person evaluation was offered.

RESULTS

A total of 85 patients (51 female, 34 male) were included, with a mean age of 50 years. The index finger was the most commonly affected location (31.8%), and the average lesion size was 17.6 mm. No atypical histological features were found. The recurrence rate confirmed by histology was 5.6% (n = 5), increasing to 10% (n = 9) when including clinically suspected cases. Statistical analysis revealed a significant association between recurrence and lesion location, with all recurrences occurring in finger joints (p = 0.013). Multivariable analysis confirmed joint-related location as an independent risk factor (odds ratio (OR) = 0.09; 95% confidence interval (CI): 0.01-0.80; p = 0.026). Post-operative complications were minimal, and patient satisfaction was high.

CONCLUSION

Our findings show a recurrence rate at the lower end of published data. Lesions involving finger joints were significantly more likely to recur. Pre-operative imaging and meticulous surgical technique are crucial to minimise recurrence and optimise outcomes.