Giant cell tumor of tendon sheath
Left hand - AT MCP joint / Proximal phalanx region - Palmer nodule - 5 yrs. Radiograph - Not available.
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Well-defined ovoid lesion is seen in region of interest. Lesion is at level of 4th Metacarpo-phalangeal joint and proximal phalanx.
Size - 25 x 21 x 10 mm. Long axis of lesion is parallal to metacarpus.
Location - Superficial to flexure tendon of 4th digit. Lesion surrounds about 180 degree of flexure tendon. It is abutting flexur tendon.
Dynemic scan shows free tendon movement from lesion.
Morphology - Heterogeneously hypoechoic , - Solid - NO calcification / cystic changes.
- Small lobulations present. - No posterior acoustic enhancement.
- NOt compressible.
Dopplar - Flow in predomimently in wall of lesion.- Central flow present.
On basis of ultrasound findgings and history of slow growth, possibility of giant cell tumor of tendon sheath was suggest.
Lesion was excised.
Histo-pathology - Giant cell tumor of tendon sheath.
- 1. Giant Cell Tumors of the Tendon Sheath: Analysis of Sonographic Findings. William D. Middleton1 Vikram Patel1 Sharlene A. Teefey1 Martin I. Boyer2. AJR:183, August 2004 337
- 2. The Value of Sonography in Diagnosing Giant Cell Tumors of the Tendon Sheath Yuexiang Wang, MD, Jie Tang, MD, Yukun Luo, MD 2007 by the American Institute of Ultrasound in Medicine • J Ultrasound Med 2007; 26:1333–1340
- 3. Giant-cell tumour of the tendon sheath in the foot and ankle C. L. M. H. Gibbons, H. A. Khwaja, A. S. Cole, P. H. Cooke, N. A. Athanasou From the Nuffield Orthopaedic Centre, Oxford, England. THE JOURNAL OF BONE AND JOINT SURGERY