Tenosynovial Giant cell Tumor of Elbow

Tenosynovial Giant cell Tumor (TGCT) of Elbow

Tenosynovial Giant cell Tumor of Elbow in a woman in her mid-20s sought medical advice due to a persistent swelling in her elbow, which had been troubling her for approximately six months. Despite the discomfort, she initially dismissed it until she noticed limitations in the mobility of her elbow, prompting her to seek medical attention.

After consulting with orthopedic specialists and oncologists, she underwent various tests, including an MRI scan. A lesion measuring 3*3 cm was detected within the elbow joint, causing restriction of movement. This was hypointense on T1 weighted, isointense on both T2 and Stir sequences. Our Orthopaedic oncology team in discussion with radiologists suspected a tumor of benign origin.

Following careful consideration, it was decided that an image-guided biopsy using a minimally invasive needle (trucut biopsy) would be performed to obtain tissue samples for diagnosis. The biopsy revealed a diagnosis of Tenosynovial giant cell tumor (nodular variant), prompting discussions on the most appropriate treatment approach to remove the tumor and prevent recurrence.

TGCT are rare proliferative disorders of synovial tissue. These are either nodular variant (TGCT) or diffuse variant (PVNS). Surgical treatment is recommended, with emphasis on complete disease clearance. The various surgical options are arthroscopic (key-hole) surgery or an open surgery.

Ultimately, the patient opted for open surgery to ensure complete removal of the tumor without any spillage. The surgery was successful, and subsequent tissue analysis confirmed the biopsy findings.

Following a rigorous rehabilitation program, the patient experienced significant improvement and regaining full elbow mobility and a disappearance of the previous deformity. Prevention of stiffness is crucial in such intra-articular tumor excisions.

Nine months post-surgery, the patient remains tumor-free and is delighted with the restoration of full elbow function, marking a successful outcome to her medical journey.