Giant cell tumor of tendon sheath

Case contributed by Maulik S Patel
Diagnosis almost certain


Palmar nodule for 5 years at the left hand's MCP joint/proximal phalanx region. Radiograph - not available.

Patient Data

Age: 40 years
Gender: Male

A well-defined ovoid lesion is seen in the region of interest at the level of the 4th metacarpophalangeal joint and proximal phalanx.

Size: 25 x 21 x 10 mm. Long axis of lesion is parallal to metacarpus.

Location: Superficial to the flexor tendon of the 4th digit. Lesion abuts and surrounds about 180 degrees of the flexor tendon.

Dynamic scan: shows free tendon movement from the lesion


  • heterogeneously hypoechoic, solid, no calcification / cystic changes
  • small lobulations present, no posterior acoustic enhancement
  • not compressible
  • Doppler flow predominantly in the wall of the lesion, central flow present

Case Discussion

On the basis of ultrasound findings and a history of slow growth, the possibility of a giant cell tumor of tendon sheath was suggested.

The lesion was excised.
Histopathology: giant cell tumor of tendon sheath

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