Giant Cell Tumors (GCT) Tendon Sheath

Giant Cell Tumors (GCT) Tendon Sheath
May 25, 2016

IMG_3674.343164936_std“Giant Cell Tumors in the Tendon Sheath are tumors that attack the sheath or the synovium of the hand or fingers being the most common after the ganglion cysts. Mildly painful they interrupt working as they are quite large and have a trait of appearing yellowish brown clearly indicating their presence”, introspects Dr. Gupta regarding GCT Tendon Sheath.
With more than 25 years of experience and 6000 surgeries Dr. Gupta knows each and every condition of upper extremity like the back of his hand and his easy reassurance is enough to calm down the anxiety of the patients.

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“The unique feature of GCT are that they predominantly appear in the right hand and the patients are relatively the younger group i.e. from 30-50 years. Usually benign in nature they rarely turn malignant or recur. But like any other tumors the only treatment option is to extract them out completely by surgical excision.”

An MBBS and MS in Ortho with intrinsic further studies from Institute of Medical in Germany and USA he has selflessly served his patients in India at AIIMS, Fortis, The Medanta and presently designated as head of the shoulder and hand division at the Max Healthcare, he has been awarded for introducing revolutionary and international techniques in Indian surgery in the field of upper extremity.

“X-Ray or MRI bone is the only way to confirm or diagnose these tumors as they have no significant symptom except perhaps a bulge. Uncomplicated in nature they can be treated painlessly and easily”.

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Unperturbed by any complication Dr. Gupta is perhaps the most skilled and deft specialists in his field and patients can trust him to rejuvenate their impaired limbs back to normal without any complexities involved.


FAQ – GCT Tendon Sheath

Giant Cell Tumors of the Tendon Sheath (GCTTS) are the most common hand and wrist tumors after the ganglion cysts which may sometimes erupt in the synovium rather than the tendon sheath. Being benign in nature and generally asymptomatic they grow in the soft tissues near the tendon and have a rare to mild recurrence trait (4 t0 40%).
Tumor simply means an abnormal growth in any part of the body that might seem like a swelling or a prominent bulge and occurs for no pliable reasons. It can be benign or malignant. Benign tumor is a growth that does not spread to other parts of the body whereas malignant tumors spread and affect the functioning of all parts of the body.
From being almost painless to mildly painful GCT Tendon Sheath are usually observed as yellow to brown prominent soft bulges on the palmar or dorsal side of the hand and distal interphalangeal joint. The patient might experience numbness and impaired movement due to the large size of the tumor and subtle sensory changes.
The age group that is more susceptible to the GCT Tendon Sheath is people between 30-50 years and females have a higher ratio of being affected by it in comparison to men.
The tumor can vary in size. It can be from 0.3 to 5 cm large .
The tumor can be found in both the hands but it affects the right hand predominantly.
Specific causes that attribute to it are still unknown/undiagnosed but theories state that GCT might be resultant of an inflammatory process.
When a bulge is observed by the physician/doctor on the hand or between fingers with mild pain then the doctor confirms the presence of GCT by imaging tests such as X-rays and MRI of the bone.
The only treatment technique of GCT is removal of these tumors by surgical excision. If the tumor is deeply embedded in the tendon sheath or joint, these structures are also removed to ensure complete removal of the tumor so that they do not recur. The technique which is undertaken is the Burner Zig Zag incision on the fingers. With a wide cut the tumor is pulled out and then the cut is stitched back with a nylon thread.
The patient should wash the stitches with soap and water and try to mobilize the hand as soon as possible else stiffness might become another problem. The prescribed medications should be taken timely to ensure healing. It is advisory to stay away from lifting heavy objects or playing contact sports for a prescribed period of time.
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