Giant Cell Tumour of Tendon Sheath (GCT)

A Giant Cell Tumour of Tendon Sheath

What is a Giant Cell Tumour?
This lump has a worrying name, because the word ‘tumour’ is often associated with cancer. Tumour is the latin term for a swelling, and a giant cell tumour is simply a swelling that contains a high number of ‘giant cells’ when it is examined under a microscope. The swelling itself is firm and often has more than one lump within the swelling.

What symptoms can it cause?
The majority of giant cell tumours grow slowly and are located in the fingers, usually near one of the small joints or over the flexor tendon. With time, the lumps can become quite large, and start to give symptoms from pressure on the surrounding tissues, preventing normal movement. They are not usually painful.

What is the natural history?
Unfortunately, these lumps tend to continue growing slowly, and therefore, most people will reach the stage where they are keen to have the lump removed surgically. Although they are harmless, the more extensive they become, the more difficult they are to completely remove surgically.

What are the risks of surgery?
All operations carry general risks including infection and damage to nerves or arteries in the finger. These lumps tend to envelop the nerves and arteries, and therefore, the risk of damage to these structures is higher than in most operations, which can leave a numb or painful finger in the long term.

Adequate surgical excision is not always possible without compromising one of the finger joints, and in this situation, the surgeon will usually opt to take away most, but not all of the lump. The lump may then take some years to re-form to its initial size. There is a high recurrence rate following removal of these lumps.

© Fife Virtual Hand Clinic 2021

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