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Giant Cell Tumour of Tendon Sheath (Lump on a Finger or Thumb)

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A giant cell tumour of tendon sheath is a common, benign (non-cancerous) lump on a finger or thumb. What causes it, how it is diagnosed and removed, and how often it comes back.

Updated Aug 20265 citations
A hand-drawn illustration of a benign soft lump on the side of a finger.
Under the microscope, a giant cell tumour of tendon sheath is made up of clusters of multinucleated giant cells (the dark, lumpy-looking cells) mixed with smaller mononuclear cells. It is benign, and it is this giant-cell appearance that gives the lesion its name. Kieran Hirpara 4.0

What you're feeling

You may notice a small, firm lump on your finger or thumb. This is a benign growth, meaning it is not cancer. It sits on the tendon sheath, which is the slippery covering that helps your tendons glide smoothly. Because of this location, the lump can feel like a hard pea under the skin. It might be painless at first, but as it grows, it can press on nearby nerves or tissues.

The lump can make everyday tasks difficult. You might find it hard to grip objects firmly. Simple actions like turning a key, opening a jar, or typing on a keyboard can become awkward or painful. The mass may interfere with the normal movement of your finger, causing a slight stiffness or a feeling that something is catching in the joint.

Pain often worsens with activity. Using your hand for repetitive tasks can irritate the area, leading to a dull ache or sharp pain. You might notice the discomfort increases after a long day of work or hobbies. Some people experience more pain at night, which can disrupt sleep if you rest your hand in a position that puts pressure on the lump.

In some cases, the growth can involve the joint capsule or the tendons themselves. This direct involvement can lead to higher risks of the lump returning after treatment. If the disease is diffuse, meaning it spreads along the tendon sheath rather than staying in one spot, symptoms may be more persistent. Complete surgical removal is usually the best way to address these issues and restore function.

While most cases are straightforward, recurrent growth is a known risk. Recurrence typically happens within 36 months of removal. If the lump returns, it may cause similar symptoms again. Your surgeon will discuss the best approach to remove the growth and its attachment site to minimise this risk. In rare cases where the growth is difficult to remove completely, other treatments like radiation therapy might be considered to control local tumour growth while preserving hand function.

What's actually happening

Giant cell tumours of the tendon sheath are benign lumps that form on your fingers or thumbs. They grow slowly within the protective lining of your tendons. These are not cancerous and do not spread to other parts of your body. However, they can cause discomfort and limit movement.

Your tendons are like ropes that connect muscle to bone. They slide through a sheath, which acts as a smooth tunnel. This condition involves the tissue inside that tunnel. The lining becomes thickened and forms a small mass. This growth presses against nearby structures. It can make your finger feel stiff or painful when you bend it.

The main challenge with these lumps is that they can return after treatment. Recurrence is the primary risk. Most returns happen within 36 months of removal. Complete surgical resection is the standard treatment. Your surgeon aims to remove the entire lump and its attachment site. This approach helps prevent the tumour from coming back.

In some cases, the disease is more diffuse. This means it spreads over a wider area rather than staying in one spot. Diffuse disease presents challenges due to higher recurrence rates. It can be harder to remove completely without affecting function. In infiltrative cases, radiation therapy may provide local tumour control. This helps preserve hand function while managing the growth.

Surgical treatment for related conditions, such as pigmented villonodular synovitis, often leads to good functional results. Patients typically regain an average of 92% of normal limb function. Long-term outcomes are generally positive, with many patients showing no evidence of recurrence after several years. Satisfactory functional results often mirror the status of the underlying joint.

Your surgeon will assess the extent of the growth. They will recommend a plan that balances complete removal with preserving your hand’s movement. The goal is to stop the lump from growing and to keep your finger working well.

What we can do about it

Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, starts with the least invasive options that suit your condition. Patients are generally referred to our clinic by their GP; if a physiotherapist has suggested you see us, you will still need a referral from your GP in order to be eligible for the Medicare rebate. A clinic assessment (history, examination, and imaging where needed) establishes the diagnosis. For degenerative or long-standing problems we usually try non-operative care — activity change, physiotherapy or hand therapy, splinting, and injections — and consider surgery when that has not given enough improvement.

Giant cell tumours of the tendon sheath are benign lumps. They are not cancer, but they can grow and cause stiffness or pain. We often begin with simple measures to manage symptoms. You might adjust how you use your hand to avoid irritating the lump. Physiotherapy can help keep your finger moving smoothly and maintain strength in your hand. Splints may support the joint if it feels unstable. These steps do not remove the lump, but they can help you live with it comfortably for a time.

If symptoms persist, we may discuss medical management to reduce discomfort. Anti-inflammatory medications can help calm the swelling around the lump. In some cases, we might consider an injection to reduce inflammation or pain. While these treatments do not cure the condition, they can provide relief for a period. It is important to note that recurrence is the primary risk with this condition, typically occurring within 36 months of any excision. This means that even if symptoms improve, the lump may return, so we monitor your progress closely.

Surgery is considered when conservative care has reached its limit and the lump continues to affect your daily life. Complete surgical excision is the treatment of choice for most patients. This involves removing the lump and its attachment site to minimise the chance of it coming back. For diffuse disease, where the tumour spreads more widely, surgery can be more challenging due to higher recurrence rates. In rare cases where the tumour is very infiltrative, radiation therapy may be used to control local growth while preserving hand function. We will discuss the best approach for your specific situation during your consultation.

What to expect

Giant cell tumours of the tendon sheath are benign lumps on your fingers or thumbs. They do not spread to other parts of the body. However, they can persist or grow if left untreated. The main risk after removal is that the lump may come back. This is known as recurrence.

Recurrence is the primary concern for this condition. If the tumour returns, it typically does so within 36 months of your surgery. In rare cases, new lumps can appear much later. One patient in the evidence had a disease-free interval of 24 years before a multicentric recurrence appeared. Because of this, your surgeon will monitor you for several years after treatment.

Complete surgical removal is the standard treatment. When the entire tumour and its attachment site are removed, outcomes are generally positive. For similar benign conditions in the hand, total excision has resulted in no local recurrences at a mean follow-up of 3.2 years. Your surgeon aims to remove the lump entirely to minimise the chance of it returning.

If the disease is diffuse or infiltrative, it presents more challenges. In such cases, radiation therapy may be used to control the tumour locally while preserving your hand function. This approach helps manage the condition when surgery alone might not be sufficient.

Most patients regain good function after treatment. For related conditions managed with surgery, patients often report functional results that are 92% of normal limb function. You should expect a gradual return to normal activities. Your surgeon will guide you on what to feel and do during this time.

While we cannot promise that the lump will never return, we aim for the best possible outcome. We will keep a close eye on your recovery. If you notice any changes or new lumps, please let us know. Early detection of any recurrence allows for timely management. Your long-term outlook is generally good with appropriate care and follow-up.

When to see someone

Giant cell tumours of the tendon sheath are benign lumps on your fingers or thumbs. While they are not cancer, they can grow back after treatment. This recurrence is the main risk. Your surgeon will watch you closely if the lump involves your tendons or joint capsule, as this raises the chance of it returning. In rare cases, a new lump can appear many years later, even 24 years after your first one. See your GP or hand specialist if you notice a new lump, or if an old one returns. They will check for signs of growth and discuss your next steps.

Advanced reading: the deeper science (optional)

This section goes further than you need for your own treatment decisions. Giant cell tumour of the tendon sheath is worth the extra reading because its defining problem is recurrence — and the evidence suggests recurrence is driven more by the biology of the individual tumour than by anything about how it is removed.

Recurrence is a property of the tumour, not only of the surgery

The instinctive explanation for a lump coming back is that some was left behind. A systematic review of 605 digital cases concluded otherwise: the intrinsic biology of the tumour appears to play a more fundamental role in recurrence than tumour location or local invasiveness — with the authors calling for larger prospective studies to identify which tumours are prone to recurrence [1].

That is a genuinely useful thing to be told before an operation. Recurrence after a well-performed excision is a recognised behaviour of this tumour rather than evidence that something went wrong.

Treatment is elective, and doing nothing is a real option

It is easy to lose sight of this once an operation is being planned. The principle of first-line treatment is complete resection, but treatment is never urgent, and the indication should be weighed against symptoms, progression, location and your own circumstances [4].

For a small, painless, slowly growing nodule, watching it is a legitimate choice. The tumour is benign and does not spread, so the argument for operating is about function, size and nuisance — not about danger.

But two surgical factors do matter

Biology is not the whole story. In 941 patients with localised-type tenosynovial giant cell tumour, the factors associated with recurrence after resection were larger tumour size and initial treatment with arthroscopy. Given relatively low complication rates and good functional outcomes, the authors recommend an open approach with complete resection where possible to reduce recurrence in high-risk cases [2].

The counterpoint is that arthroscopic excision has been shown effective for the localised type across four joints in a review of 1,448 patients — while in the diffuse type, arthroscopic synovectomy has demonstrated efficacy only at the knee [3].

Reconciling these: for a small, localised, well-defined lesion, either approach can work. As size increases, and for the diffuse form, complete open excision is better supported. The reason is mechanical — this tumour extends in fronds around tendon, nerve and joint, and the parts most easily missed are the ones tucked behind structures that must be lifted and inspected directly.

Why the naming matters

The condition now sits under tenosynovial giant cell tumour, which covers both the localised form in the hand and the diffuse intra-articular form previously called pigmented villonodular synovitis [4]. They are the same entity in different locations and growth patterns.

This is worth knowing if you read around the subject, because a search will return material about knees and hips that is describing your condition in its diffuse form — and the recurrence rates quoted for the diffuse disease are considerably higher than those for a localised digital lesion. Applying knee figures to a finger lump overstates the risk.

Where radiotherapy sits

For diffuse disease that has recurred or cannot be completely excised, adjuvant radiotherapy is sometimes considered. A meta-analysis found that open synovectomy — or synovectomy combined with perioperative radiotherapy — was associated with a reduced rate of recurrence in diffuse pigmented villonodular synovitis, while calling for large long-term prospective studies to confirm it [5].

For a localised digital tumour, which is the great majority of hand cases, this does not arise. It belongs to the diffuse, recurrent, joint-based end of the spectrum, and is mentioned here only because a search on the condition name will surface it.

What it is not

Despite the name, this is a benign tumour. It does not spread elsewhere in the body. The word "tumour" carries weight it does not deserve here, and the concern with recurrence is about repeated local surgery, stiffness and nerve proximity — not about cancer.

Reviewed by Kieran Hirpara · 28 April 2026.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

References for the advanced reading
  1. Fotiadis E, Papadopoulos A, Svarnas T, Akritopoulos P, Sachinis NP, Chalidis BE. Giant cell tumour of tendon sheath of the digits. A systematic review. Hand (N Y). 2011;6(3):244-9.
  2. Mastboom M, Staals E, Verspoor F, Rueten-Budde A, Stacchiotti S, Palmerini E, et al. Surgical treatment of localized-type tenosynovial giant cell tumors of large joints: a study based on a multicenter-pooled database of 31 international sarcoma centers. J Bone Joint Surg Am. 2019;101(14):1309-18.
  3. Noailles T, Brulefert K, Briand S, Longis P, Andrieu K, Chalopin A, et al. Giant cell tumor of tendon sheath: open surgery or arthroscopic synovectomy? A systematic review of the literature. Orthop Traumatol Surg Res. 2017;103(5):809-14.
  4. Gouin F, Noailles T. Localized and diffuse forms of tenosynovial giant cell tumor (formerly giant cell tumor of the tendon sheath and pigmented villonodular synovitis). Orthop Traumatol Surg Res. 2017;103(1):S91-S97.
  5. Mollon B, Lee A, Busse JW, Griffin AM, Ferguson PC, Wunder JS, et al. The effect of surgical synovectomy and radiotherapy on the rate of recurrence of pigmented villonodular synovitis of the knee. Bone Joint J. 2015;97-B(4):550-7.
Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Giant cell tumors of the tendon sheaths in the hand are benign lesions [2, 3].
  • Recurrence is the primary risk associated with giant cell tumors of the tendon sheaths in the hand [2, 3].
  • Recurrence of giant cell tumors of the tendon sheaths in the hand typically occurs within 36 months of excision [2].
  • Complete surgical resection remains the treatment of choice for most patients with tenosynovial giant cell tumors [6].
  • Diffuse disease in tenosynovial giant cell tumors presents challenges due to high recurrence rates [6].
  • In cases of infiltrative giant cell tumor of the tendon sheath, radiation therapy may provide local tumor control with preservation of hand function [1].
  • Total surgical excision ensuring removal of the attachment site (flexor sheath/palmar fascia) resulted in no local recurrences at a mean follow-up of 3.2 years for fibroma of the tendon sheath [7].
  • Well-designed studies combining the recurrence rates of several hand surgery centers implementing a standardized treatment are needed to better demonstrate the associated risk factors for recurrence of giant cell tumor of the tendon sheath in the hand [8].

Anatomy & Pathophysiology

  • Radiation therapy may provide local tumor control with preservation of hand function in cases of infiltrative Giant Cell Tumor of the Tendon Sheath (GCTTS) [1].
  • Surgical treatment for Pigmented Villonodular Synovitis (PVNS) led to good functional results with an average Enneking score of 92% of normal limb function [10].
  • Patients with diffuse Pigmented Villonodular Synovitis reported good functional outcomes without evidence of recurrence in a 19-patient cohort with an average follow-up of almost 7 years [22].
  • Satisfactory functional results in diffuse Pigmented Villonodular Synovitis mirror the status of the underlying joint [42].

Classification

  • Giant cell tumors of the synovial sheaths in the hand are benign lesions [3].
  • Tenosynovial giant cell tumors include pigmented villonovular synovitis [6].
  • Fibroma of the tendon sheath is a distinct entity from giant cell tumor of the tendon sheath [7].
  • Epiphyseal chondromatous giant cell tumors represent a distinct clinical entity of essentially benign giant cell tumors [9].
  • Giant cell tumors of bone in the hand are a rare condition [4].
  • Giant cell tumors of the distal radius are classified into Grades 1, 2, and 3 [14].
  • Tumors with extension limited to a single site of palmar cortical perforation are classified as grade 3(p) [35].
  • Campanacci grade III giant cell tumours of the distal radius are a specific classification subset [40].
  • Direct involvement of the extensor tendons, flexor tendons, or joint capsule places patients in a high-risk category with respect to recurrence [25].
  • Grade III lesions, particularly with extensive soft tissue involvement, represent a subset of patients at higher risk of recurrence [18, 12].

Clinical Presentation

  • Giant cell tumors of the tendon sheaths in the hand are benign synovial neoplasms [21].
  • Giant cell tumors of the tendon sheaths in the hand have the potential for local recurrence [21].
  • Recurrence is the primary risk for giant cell tumors of the tendon sheaths in the hand [2, 3].
  • Direct involvement of the extensor tendons, flexor tendons, or joint capsule puts patients in a high-risk category with respect to recurrence [25].

Investigations

  • Radiation therapy may provide local tumor control with preservation of hand function in cases of infiltrative giant cell tumor of the tendon sheath [1].
  • Giant cell tumors of the tendon sheaths in the hand are benign lesions where recurrence is the primary risk, typically occurring within 36 months of excision [2].
  • Giant cell tumors of the synovial sheaths in the hand are benign lesions in which recurrence is the primary risk [3].
  • Complete surgical resection remains the treatment of choice for most patients with tenosynovial giant cell tumors, though diffuse disease presents challenges due to high recurrence rates [6].
  • Total surgical excision ensuring removal of the attachment site (flexor sheath/palmar fascia) resulted in no local recurrences at a mean follow-up of 3.2 years for fibroma of tendon sheath of the hand [7].
  • Pigmented villonoid synovitis and giant-cell tumor of tendon sheath are benign synovial neoplasms with the potential for local recurrence [21].
  • Although MRI findings and location might help in the diagnosis of a tenosynovial giant cell tumor, careful assessment is mandatory, especially in unusual locations [33].
  • Pigmented villonodular synovitis of the shoulder is extremely rare, with clinical and radiological findings generally being nonspecific and often mimicking a malignancy [38].

Treatment

  • Both curettage and resection/amputation are acceptable treatment options for giant cell tumour of bone in the hand, with treatment decisions needing to be individualized based on the site and extent of disease to minimize morbidity while maximizing disease control [4].
  • Intralesional excision remains a viable, and likely the standard, mode of treatment for most giant cell tumors of the distal radius unless there is extensive bone loss [5].
  • Well-designed studies combining the recurrence rates of several hand surgery centers implementing a standardized treatment are needed to better demonstrate the associated risk factors for recurrence in giant cell tumor of tendon sheath in the hand [8].
  • Conservative treatments yielded good results without amputation for epiphyseal chondromatous giant cell tumors of the upper end of the humerus [9].
  • Centralization of the ulna is a simple and effective modality of reconstruction following resection of Campanacci Grade 3 giant cell tumor of the distal radius [11].
  • En bloc resection and matched nonvascularized toe phalangeal transfer for Campanacci Grade 2 or 3 giant cell tumor of the phalanges resulted in a functional tumor-free digit with a low complication rate and no recurrences [13].
  • Intralesional excision appears to be more appropriate for the treatment of local lesions (Grades 1 and 2) than Grade 3 giant cell tumors of the distal radius [14].
  • The use of a massive biocompatible bipolar unconstrained prosthesis is a viable treatment option for distal radius reconstruction after en-bloc resection of a giant cell tumour, offering rapid functional improvement without donor-site morbidity [17].
  • Selective use of curettage and cementing is recommended in Grade III giant cell tumor lesions, particularly with extensive soft tissue involvement [18].
  • Intralesional excision with cautery and methylmethacrylate provides a reliable method of treatment of giant cell tumors with good long-term functional results [19].
  • Intralesional excision with local adjuvant therapy is recommended for the treatment of giant cell tumor of bone because it results in a good functional outcome compared to extralesional excision [27].
  • Repeated curettage with adjuvants eventually resulted in the cure for all patients and is therefore a reasonable treatment for both primary and recurrent giant cell tumor of the small bones of the hands and feet [28].
  • Reconstruction after wide excision by nonvascularized fibular graft is a viable alternative for giant cell tumors of the lower end of radius, though it is a challenging procedure that may be accompanied by major complications [29].
  • Non-surgical treatment has a similar risk of complications to intralesional nerve-sparing surgery and has better functional outcomes than intralesional nerve-sparing surgery for giant cell tumor of the sacrum, but patients must remain on therapy over time [32].

Complications

  • Well-designed studies combining recurrence rates from several hand surgery centers are needed to better demonstrate associated risk factors for recurrence [8].
  • Subsets of patients with giant cell tumor of bone are at higher risk of recurrence and should be clinically followed more closely [12].
  • Metachronous multicentric giant cell tumor can present with long disease-free intervals, such as 24 years between initial presentation and multicentric recurrence [15].

Recovery

  • Recurrence is the primary risk for giant cell tumors of the tendon sheaths in the hand, typically occurring within 36 months of excision [2].
  • Recurrence is the primary risk for giant cell tumors of the synovial sheaths in the hand [3].
  • Surgical treatment of pigmented villonous synovitis led to good functional results with an average Enneking score of 92% of normal limb function [10].
  • A patient with metachronous multicentric giant cell tumor had a disease-free interval of 24 years between the initial presentation and the multicentric recurrence [15].
  • The distal ulna may be widely resected with or without stabilization of the residual ulnar stump, yielding satisfactory local disease control and functional outcome [20].
  • Patients with pigmented villonous synovitis of the hip managed with arthroscopic synovectomy reported good functional outcomes without evidence of recurrence in a cohort with an average follow-up of almost 7 years [22].
  • Tumor resection with negative margins is supported for giant cell tumors in the radius [26].

Key Evidence

  • [L4] In cases of infiltrative GCTTS, radiation therapy may provide local tumor control with preservation of hand function. [1] (10.1016/j.jhsa.2012.01.011)
  • [L4] Giant cell tumors of the tendon sheaths in the hand are benign lesions where recurrence is the primary risk, typically occurring within 36 months of excision. [2] (10.1016/j.otsr.2013.03.008)
  • [L4] Giant cell tumors of the synovial sheaths in the hand are benign lesions in which recurrence is the primary risk. [3] (10.1016/j.jhsa.2013.08.051)
  • [L4] Both curettage and resection/amputation are acceptable treatment options for the rare condition of giant cell tumour of bone in the hand, with a need to individualize treatment decisions based on the site and extent of disease to minimize treatment morbidity while maximizing disease control. [4] (10.1177/17531934211007820)
  • [L3] Intralesional excision remains a viable, and likely the standard, mode of treatment for most giant cell tumors of the distal radius unless there is extensive bone loss. [5] (10.1007/s11999-014-4054-3)
  • [L5] Complete surgical resection remains the treatment of choice for most patients with tenosynovial giant cell tumors, though diffuse disease presents challenges due to high recurrence rates. [6] (10.5435/jaaos-d-24-01255)
  • [L4] Total surgical excision ensuring removal of the attachment site (flexor sheath/palmar fascia) resulted in no local recurrences at a mean follow-up of 3.2 years. [7] (10.1177/1753193412469146)
  • [L3] Well-designed studies combining the recurrence rates of several hand surgery centers implementing a standardized treatment are needed to better demonstrate the associated risk factors for recurrence. [8] (10.1186/s12891-019-2866-8)
  • [L4] The author concludes that these tumors represent a distinct clinical entity of essentially benign giant cell tumors that should be recognized in the literature, noting that conservative treatments yielded good results without amputation. [9] (10.1097/01.blo.0000229309.90265.df)
  • [L4] Surgical treatment led to good functional results with an average Enneking score of 92% of normal limb function. [10] (10.1097/01.blo.0000224051.01873.fb)
  • [L4] This is a simple and effective modality of reconstruction after resection of distal radial tumors. [11] (10.1016/j.jhsa.2022.05.011)
  • [L4] Our observations suggest there are subsets of patients with giant cell tumor of bone who are at higher risk of recurrence and should be clinically followed more closely. [12] (10.1007/s11999-011-2172-8)
  • [L4] En bloc resection and matched nonvascularized toe phalangeal transfer resulted in a functional tumor-free digit with a low complication rate and no recurrences. [13] (10.1016/j.jhsa.2024.06.013)
  • [L3] Based on data obtained from the number of studies available, intralesional excision appears to be more appropriate for the treatment of local lesions (eg, Grades 1 and 2) than Grade 3 GCTs of the distal radius. [14] (10.1007/s11999-012-2464-7)
  • [L4] This patient has the longest disease-free interval of a metachronous multicentric giant cell tumor reported to date, with 24 years passing between the initial presentation and the multicentric recurrence. [15] (10.1097/01.blo.0000068770.86536.e1)
  • [Case_report] The use of a massive biocompatible bipolar unconstrained prosthesis is a viable treatment option for distal radius reconstruction after en-bloc resection of a giant cell tumour, offering rapid functional improvement without donor-site morbidity. [17] (10.1016/j.otsr.2013.04.001)
  • [L4] We recommend selective use of this procedure in Grade III lesions, particularly with extensive soft tissue involvement. [18] (10.4103/0019-5413.77138)
  • [L4] Intralesional excision with cautery and methylmethacrylate provides a reliable method of treatment of giant cell tumors with good long-term functional results. [19] (10.1097/01.blo.0000128280.59965.e3)
  • [L3] The distal ulna may be widely resected with or without stabilization of the residual ulnar stump, yielding satisfactory local disease control and functional outcome. [20] (10.1177/1558944717743598)
  • [L4] Pigmented villonoid synovitis and giant-cell tumor of tendon sheath are benign synovial neoplasms with the potential for local recurrence. [21] (10.2106/00004623-198466010-00012)
  • [L4] Patients reported good functional outcomes without evidence of recurrence in a 19 patient cohort with an average follow-up of almost 7 years. [22] (10.1177/2325967119s00413)
  • [L3] Direct involvement of the extensor tendons, flexor tendons, or joint capsule puts patients in a high-risk category with respect to recurrence. [25] (10.1016/j.jhsa.2009.12.004)
  • [L4] Findings support tumor resection with negative margins in the radius. [26] (10.1016/j.jhsa.2017.06.079)
  • [L3] Intralesional excision with local adjuvant therapy is recommended for the treatment of giant cell tumor of bone because it results in a good functional outcome compared to extralesional excision. [27] (10.1007/s004020100317)
  • [L3] Repeated curettage with adjuvants eventually resulted in the cure for all patients and is therefore a reasonable treatment for both primary and recurrent GCT of the small bones of the hands and feet. [28] (10.1302/0301-620x.95b6.30876)
  • [L4] Reconstruction after wide excision by nonvascularized fibular graft is a viable alternative for giant cell tumors of the lower end of radius though it is a challenging procedure and may be accompanied by major complications. [29] (10.1007/s00402-010-1059-6)
  • [L3] Non-surgical treatment has a similar risk of complications to intralesional nerve-sparing surgery and has better functional outcomes than intralesional nerve-sparing surgery, but patients must remain on therapy over time. [32] (10.1186/s12891-021-04907-0)
  • [L4] Although MRI findings and location might help in the diagnosis of a T-GCT, careful assessment is mandatory, especially in unusual locations. [33] (10.1186/s12891-016-1050-7)
  • [L4] Tumors with extension limited to a single site of palmar cortical perforation are classified as grade 3(p) and can be treated with intralesional treatment alone. [35] (10.1016/j.jhsa.2010.07.010)
  • [Case_report] PVNS of the shoulder is extremely rare, with clinical and radiological findings generally being nonspecific and often mimicking a malignancy. [38] (10.1007/s001670050158)
  • [L4] En bloc resection of Campanacci grade III giant cell tumours of the distal radius may reduce the local recurrence rate, and a prosthesis reconstruction is still an alternative option. [40] (10.1186/s12891-025-08851-1)
  • [L4] The satisfactory functional results mirror the status of the underlying joint. [42] (10.1097/01.blo.0000229345.57092.a2)

References

[1] Radiation Therapy for Infiltrative Giant Cell Tumor of the Tendon Sheath. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2012.01.011

[2] Giant cell tumors of the tendon sheaths in the hand: Review of 96 patients with an average follow-up of 12 years. Orthopaedics & Traumatology: Surgery & Research. 2013. DOI: 10.1016/j.otsr.2013.03.008

[3] Giant Cell Tumors of the Tendon Sheaths in the Hand: Review of 96 Patients With an Average Follow-Up of 12 Years. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.08.051

[4] Giant cell tumour of hand bones: outcomes of treatment. Journal of Hand Surgery (European Volume). 2021. DOI: 10.1177/17531934211007820

[5] Is Intralesional Treatment of Giant Cell Tumor of the Distal Radius Comparable to Resection With Respect to Local Control and Functional Outcome?. Clinical Orthopaedics & Related Research. 2015. DOI: 10.1007/s11999-014-4054-3

[6] Tenosynovial Giant Cell Tumor and Pigmented Villonodular Synovitis. Journal of the American Academy of Orthopaedic Surgeons. 2025. DOI: 10.5435/jaaos-d-24-01255

[7] Fibroma of tendon sheath of the hand: a series of 20 patients with 23 tumours. Journal of Hand Surgery (European Volume). 2012. DOI: 10.1177/1753193412469146

[8] Giant cell tumor of tendon sheath in the hand: analysis of risk factors for recurrence in 50 cases. BMC Musculoskeletal Disorders. 2019. DOI: 10.1186/s12891-019-2866-8

[9] THE CLASSIC: Epiphyseal Chondromatous Giant Cell Tumors of the Upper End of the Humerus. Clinical Orthopaedics and Related Research. 2006. DOI: 10.1097/01.blo.0000229309.90265.df

[10] What Affects the Recurrence and Clinical Outcome of Pigmented Villonodular Synovitis?. Clinical Orthopaedics and Related Research. 2006. DOI: 10.1097/01.blo.0000224051.01873.fb

[11] Functional Outcomes of Centralization of the Ulna as a Method of Reconstruction Following Resection of Campanacci Grade 3 Giant Cell Tumor of the Distal Radius. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2022.05.011

[12] Giant Cell Tumor of Bone: Are We Stratifying Results Appropriately?. Clinical Orthopaedics & Related Research. 2012. DOI: 10.1007/s11999-011-2172-8

[13] Campanacci Grade 2 or 3 Giant Cell Tumor of the Phalanges: En Bloc Resection and Matched Nonvascularized Toe Phalangeal Transfer. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2024.06.013

[14] Which Treatment is the Best for Giant Cell Tumors of the Distal Radius? A Meta-analysis. Clinical Orthopaedics & Related Research. 2012. DOI: 10.1007/s11999-012-2464-7

[15] Metachronous Multicentric Giant Cell Tumor: A Case Report and Literature Review. Clinical Orthopaedics & Related Research. 2003. DOI: 10.1097/01.blo.0000068770.86536.e1

[17] Massive wrist prosthesis for giant cell tumour of the distal radius: A case report with a 3-year follow-up. Orthopaedics & Traumatology: Surgery & Research. 2013. DOI: 10.1016/j.otsr.2013.04.001

[18] Local recurrences after curettage and cementing in long bone giant cell tumor. Indian Journal of Orthopaedics. 2011. DOI: 10.4103/0019-5413.77138

[19] Results of Giant Cell Tumor of Bone Treated With Intralesional Excision. Clinical Orthopaedics & Related Research. 2004. DOI: 10.1097/01.blo.0000128280.59965.e3

[20] Extensor Carpi Ulnaris Tenodesis Versus No Stabilization After Wide Resection of Distal Ulna Giant Cell Tumors. HAND. 2017. DOI: 10.1177/1558944717743598

[21] Pigmented villonodular synovitis (giant-cell tumor of the tendon sheath and synovial membrane). A review of eighty-one cases.. The Journal of Bone & Joint Surgery. 1984. DOI: 10.2106/00004623-198466010-00012

[22] Pigmented Villonodular Synovitis of the Hip Managed with Arthroscopic Synovectomy: An Analysis of 19 Cases with up to 10-year Follow-up. Orthopaedic Journal of Sports Medicine. 2019. DOI: 10.1177/2325967119s00413

[25] Recurrence of Giant Cell Tumors in the Hand: A Prospective Study. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2009.12.004

[26] Factors Associated with Recurrent Giant Cell Tumors of the Upper Extremity. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.06.079

[27] Oncologic and functional results after treatment of giant cell tumors of bone. Archives of Orthopaedic and Trauma Surgery. 2001. DOI: 10.1007/s004020100317

[28] Giant cell tumours of the small bones of the hands and feet. The Bone & Joint Journal. 2013. DOI: 10.1302/0301-620x.95b6.30876

[29] Autogenous non-vascularized fibula for treatment of giant cell tumor of distal end radius. Archives of Orthopaedic and Trauma Surgery. 2010. DOI: 10.1007/s00402-010-1059-6

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