El ve El Bileği Yerleşimli Tendon Kılıfının Dev Hücreli Tümörü: 42 Hastanın Retrospektif Analizi

Tendon kılıfının dev hücreli tümörü (TKDHT), ganglion kistinden sonra elde en sık görülen benign yumuşak doku tümörüdür. Çalışmamızda el ve el bileği yerleşimli TKDHT nedeniyle ameliyat edilen 42 hastanın demografik, klinik, radyolojik ve histopatolojik özellikleri ile cerrahi sonrası nüks oranları güncel literatür eşliğinde tartışıldı. Çalışmamızda; kadın/erkek oranı: 2.5/1, ortalama yaş 40.23±14.86, hastaların %64.28’ inde tümör volar bölgeye lokalize, elde en sık lokalizasyon başparmak (%33.3), parmaklarda ise en sık lokalizasyon proksimal falanks (%35,71) olup, bulgular literatür verileriyle uyumluydu. Serimizde şikayetin başlangıcından cerrahiye kadar geçen ortalama zaman 5.4 ay olarak bulundu. Nüks gelişen 2 hastada (%4.76) tümör volar bölgeden başlayıp dorsal bölgeye doğru uzanmaktaydı ve muhtemel nüks nedeni geride satellit lezyon kalmasıydı. Sonuç olarak TKDHT benign karakterine rağmen lokal agresif bir tümördür. Nüks oranlarını azaltmak için büyütücü gözlük altında, geniş bir cerrahi sahada, titiz bir cerrahi uygulanmalı, özellikle hem volar hem de dorsal bölgeye lokalize olan tümörlerde geride satellit lezyon bırakmamak için ayrı insizyonlar kullanılması akılda bulundurulmalıdır.

Anahtar Kelimeler:

Tendon kılıfı, Dev hücreli tümör

Giant Cell Tumour of the Tendon Sheath of the Hand and Wrist: Retrospective Analysis of 42 Patients

Giant cell tumour of the tendon sheath (GCTTS) is the second most common benign soft tissue tumour of the hand after the ganglion cyst. In our study, demographic, clinical, radiological and histopathological features and recurrence rates of 42 patients who had been operated for hand and wrist located GCTTS were discussed with the current literature. In our study; female/male ratio: 2.5/1, average age 40.23±14.86, 64.28% of patients localized to the tumour volar side, the most common localization thumb (33.3%) in the hand, the most common localization of the proximal phalanx in the fingers (35.71%), findings were consistent with literature data. In our series, the average time from the beginning of the complaint to surgery was found to be 5.4 months. In 2 patients (4.76%) who developed recurrence, the tumours started from the volar side was reaching to the dorsal side, and the reason for the possible recurrence was the remaining satellite lesions. As a result, GCTTS is a locally aggressive tumour despite its bening character. To reduce the recurrence rate, a meticulous surgery should be performed under magnifying loupe, in a large surgical area, especially in tumours that are localized to both the volar and dorsal sides, and separate incisions should be considered in order not to leaving behind satellite lesions.

Keywords:

Tendon sheath, Giant cell tumour,

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