Journal of the Chinese Medical Association
Volume 73, Issue 1 , Pages 47-51, January 2010

Giant Cell Tumor of the Tendon Sheath in the Knee of an 11-year-old Girl

Department of Orthopaedics, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia

Received 11 February 2009; accepted 3 November 2009.

Article Outline

Giant cell tumors are commonly found over the flexor tendon sheath of the hand and wrist. However, giant cell tumors in the knee joint are rare, especially in children. We report an interesting case of an 11-year-old girl who presented with a painful lump on her right knee that enlarged over time. Clinically, she had fullness over the anterolateral part of her knee. Magnetic resonance imaging revealed an encapsulated mass inferior to the patella. The tumor measured 3 × 3.5 × 1.5 cm. Histopathological findings confirmed that it was a tenosynovial giant cell tumor. Because of initial mild symptoms, there was a delay of 2 years from the initial symptoms until tumor excision. Her follow-up period was 35 months, and her health to date is excellent with no recurrence. We believe that reporting this rare case will help clinicians update their knowledge on possible causes of lumps in the knee, and avoid diagnostic delay. It could also prove to be beneficial in arriving at a diagnosis in future cases.

Key Words:  diagnosis , giant cell tumor , histopathology , knee , MRI , pediatric

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Sharma H , Jane MJ , Reid R . Pigmented villonodular synovitis: diagnostic pitfalls and management strategy . Curr Orthop . 2005;19:215–222
  2. Gholve P , Hosalkar HS , Kreiger PA , Dormans JP . Giant cell tumor of tendon sheath: largest single series in children . J Pediatr Orthop . 2007;27:67–74
  3. Ushijima M , Hashimoto H , Tsuneyoshi M . Giant cell tumor of the tendon sheath (nodular tenosynovitis): a study of 207 cases to compare the large joint group with the common digit group . Cancer . 1986;57:875–884
  4. Rodrigues C , Desai S , Chinoy R . Giant cell tumor of the tendon sheath: a retrospective study of 28 cases . J Surg Oncol . 1998;68:100–103
  5. Bruns J , Yazigee O , Habermann CR . Pigmented villo-nodular synovitis and tenosynovial giant-cell tumors . Z Orthop Unfall . 2008;146:663–675 [In German]
  6. Jaffe HL , Lichtenstein L , Suro CJ . Pigmented villonodular synovitis, bursitis and tenosynovitis . Arch Pathol . 1941;31:731–765
  7. Relwani J , Factor D , Khan F , Dutta A . Giant cell tumor of the patellar tendon sheath–an unusual cause of anterior knee pain: a case report . Knee . 2003;10:145–148
  8. Neubauer P , Weber K , Miller NH , McCarthy EF . Pigmented villonodular synovitis in children: a report of six cases and review of the literature . Iowa Orthop J . 2007;27:90–94
  9. Grover R , Grobbelaar AO , Richman PT , Smith PJ . Measurement of invasive potential provides an accurate prognostic marker for giant cell tumor of tendon sheath . J Hand Surg Br . 1998;23:728–731
  10. Yoo JH , Yang BK , Park JM . Localized nodular synovitis of the knee presenting as anterior knee pain: a case report . Knee . 2007;14:398–401
  11. Balsara ZN , Stainken BF , Martinez AJ . MR image of localized giant cell tumor of the tendon sheath involving the knee . J Comput Assist Tomogr . 1989;13:159–162
  12. Jones FE , Soule EH , Coventry MB . Fibrous xanthoma of synovium (giant cell tumor of tendon sheath, pigmented nodular synovitis): a study of one hundred and eighteen cases . J Bone Joint Surg Am . 1969;51:76–86
  13. Ozalp T, Yercan H, Okcu G, Ozdemir O, Coskunol E, Begue T, et al. Giant-cell tumors of the tendon sheath involving the hand or the wrist: an analysis of 141 patients . Acta Orthop Traumatol Turc . 2004;38:1202–1204 [In Turkish]
  14. Al Qattan MM . Giant cell tumor of tendon sheath: classification and recurrence rate . J Hand Surg Br . 2001;261:72–75

PII: S1726-4901(10)70022-8

doi:10.1016/S1726-4901(10)70022-8

Journal of the Chinese Medical Association
Volume 73, Issue 1 , Pages 47-51, January 2010

Article Tools