Tenosynovial giant cell tumor (finger)

Case contributed by Dr Maulik S Patel

Presentation

Presented with a complaint of the left little finger nodule on the palmar side for the last months. No trauma/ pain/ skin changes/ tingling.

Patient Data

Age: 40 years
Gender: Female
Ultrasound

There is a well-defined lobulated lesion in the region of interest.

Size      

  • 14 mm (length) x 10 mm (transverse) x 5 mm (anteroposterior) 

Location

  • the lesion is on the palmar side of the distal interphalangeal joint level
  • it shows mild dorsal side extension on the ulnar side
  • it abutts the flexure tendon
  • ulnar side neuro-vascular bundle is elevated by the lesion
  • it is separate from tendon/bone/joints

Dynamic scan

  • free flexure tendon movements from the lesion       

 Morphology

  • solid
  • hypoechoic, mild heterogeneous
  • posterior acoustic enhancement present
  • no calcification / cystic changes
  • not compressible

Doppler    

  • no intralesional flow signals
  • both digital arteries are patent

Adjacent bone cortex

  • no erosion

Flexure tendon

  • intact with normal echopattern
  • no tenosynovitis

Interphalangeal joints

  • no effusion

There is a lesion on the palmar side of the little finger. It overlies the middle phalanx region. The gross specimen photos show complete excision.

Case Discussion

An adult female presented with a painless finger nodule. Ultrasound features favored a possibility tenosynovial giant cell tumor. Surgical excision of the lesion was done and histopathology confirmed the lesion being tenosynovial giant cell tumor. It is the most common soft-tissue lesion of the hand and wrist 1.

Intraoperative and gross pathology photos courtesy: Operating surgeon Dr. Nisarg A. Patel.

PlayAdd to Share

Case information

rID: 74177
Published: 8th Feb 2020
Last edited: 8th Feb 2020
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.