Diagnosis and surgical treatment of giant cell tumor in hands and feet

Chen Shuxin, Huang Yuxin, Chen Huiyang, Z. Yufeng
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Abstract

Objective To explore the clinical characteristics of giant cell tumor (GCT) in hands and feet, and to evaluate the effect of surgical treatment. Methods The clinical data of 11 patients with GCT in hands and feet treated at our hospital from 1998 to 2012 and followed up, 5 male and 6 female, were retrospectively analyzed. They were 15-41 years old, with an average of 23.5. Among the 11 cases, 4 had the tumor in hands, and 7 in feet. All the patients had pain, swelling, movement restriction on the lesion part, and came to hospital 3-14 months (average 8 months) after the sighs of the symptoms. No case got Campanacci’s grade I, 6 grade Ⅱ, and 5 gradeⅢ. One case had toe excision, and the rest were treated with extensive curettage and bone graft. Results The patients were followed up 16-120 months (average 49 months) after surgery. One of them had local recurrence after the first resection, and the metacarpal bone was resected and followed up 3 years, and found no recurrence; the rest patients had no pain and other complications after the surgery. The postoperative pathological results showed that all the patients were GCT with no malignancy, multiple center lesion, and lung metastasis. Conclusion GCT in hands and feet is rare, and tend to be misdiagnosed. The results of the present study suggest that extensive curettage provides favorable local control and achieve better clinical results. Key words: Giant cell tumor; Hands; Feet; Surgery; Diagnosis
手足巨细胞瘤的诊断与外科治疗
目的探讨手足巨细胞瘤的临床特点,评价手术治疗的效果。方法回顾性分析我院1998~2012年收治并随访的11例手足GCT患者的临床资料,其中男5例,女6例。他们年龄在15-41岁之间,平均23.5岁。11例中,手部肿瘤4例,脚部肿瘤7例。所有患者均出现病变部位疼痛、肿胀、活动受限,症状缓解后3~14个月(平均8个月)入院。CampanacciⅠ级无一例,Ⅱ级6例,Ⅲ级5例。一例进行了足趾切除术,其余病例进行了广泛的刮除和骨移植。结果术后随访16~120个月,平均49个月。其中1例首次切除后局部复发,掌骨切除随访3年,未发现复发;其余患者术后无疼痛及其他并发症。术后病理结果显示,所有患者均为GCT,无恶性肿瘤、多中心病变和肺转移。结论手足GCT少见,易误诊。本研究的结果表明,广泛刮除术提供了良好的局部控制,并取得了更好的临床效果。关键词:巨细胞瘤;手;脚;外科;诊断
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