Giant cell tumor of tendon sheath; nodular tenosynovitis
No longer recommended: extraarticular pigmented villonodular synovitis (PVNS)
Definitions
TSGCT: group of lesions most often arising from synovium of joints, bursae, and tendon sheaths, which demonstrates synovial differentiation
Similar pathologic entity to what formerly was referred to as PVNS
Usually divided according to site (intra- vs. extraarticular) and growth pattern (localized vs. diffuse)
Diffuse: most intraarticular; rarely extraarticular
Localized: intraarticular at knee (focal nodular synovitis) and extraarticular lesions
Tenosynovial Giant Cell Tumor, Extraarticular
Uncommon, rarely metastasizing fibrohistiocytic tumor representing extraarticular soft tissue form of TSGCT
Malignant Tenosynovial Giant Cell Tumor
De novo or transformation after multiple recurrences
Prevalence of malignant transformation of TSGCT is ~ 3%
IMAGING
General Features
Radiographic Findings
MR Findings
Imaging Recommendations
Ultrasonographic Findings
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Bernthal NM et al: The diffuse-type tenosynovial giant cell tumor (dt-TGCT) patient journey: a prospective multicenter study. Orphanet J Rare Dis. 16(1):191, 2021
Ota T et al: Tumor location and type affect local recurrence and joint damage in tenosynovial giant cell tumor: a multi-center study. Sci Rep. 11(1):17384, 2021
De Saint Aubain Somerhausen N et al: Tenosynovial giant cell tumor. In Fletcher CDM et al: WHO Classification of Tumours: Soft Tissue and Bone Tumours. 5th ed. IARC Press. 133-6, 2020
Brahmi M et al: Long term term follow-up of tyrosine kinase inhibitors treatments in inoperable or relapsing diffuse type tenosynovial giant cell tumors (dTGCT). PLoS One. 15(5):e0233046, 2020
Savvidou OD et al: Extra-articular diffuse giant cell tumor of the tendon sheath: a report of 2 cases. Arch Bone Jt Surg. 4(3):273-6, 2016
Righi A et al: Metastasizing tenosynovial giant cell tumour, diffuse type/pigmented villonodular synovitis. Clin Sarcoma Res. 5:15, 2015
Palmerini E et al: Tenosynovial giant cell tumour/pigmented villonodular synovitis: outcome of 294 patients before the era of kinase inhibitors. Eur J Cancer. 51(2):210-7, 2014
Kransdorf MJ et al: Fibrous and fibrohistiocytic tumors and synovial tumors. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 3rd ed. Lippincott Williams & Wilkins. 330, 462-9, 2014
Bancroft LW et al: Imaging of benign soft tissue tumors. Semin Musculoskelet Radiol. 17(2):156-67, 2013
Zeinstra JS et al: Multifocal giant cell tumor of the tendon sheath: case report and literature review. Skeletal Radiol. 42(3):447-50, 2013
Fotiadis E et al: Giant cell tumour of tendon sheath of the digits. A systematic review. Hand (N Y). 6(3):244-9, 2011
Walker EA et al: Magnetic resonance imaging of benign soft tissue neoplasms in adults. Radiol Clin North Am. 49(6):1197-217, vi, 2011
Pallas A et al: Intense FDG uptake in an intra-articular localized giant-cell tumor of the tendon sheath (pigmented villonodular synovitis) mimics metastatic melanoma. Radiol Case Rep. 4(4):343, 2009
Bancroft LW et al: Imaging of soft tissue lesions of the foot and ankle. Radiol Clin North Am. 46(6):1093-103, vii, 2008
Weiss SW et al: Benign tumors and tumor-like lesions of synovial tissue. In Weiss SW et al: Enzinger and Weiss' Soft Tissue Tumors. 5th ed. Elsevier. 770-7, 2008
Sanghvi DA et al: Diffuse-type giant cell tumor of the subcutaneous thigh. Skeletal Radiol. 36(4):327-30, 2007
Posligua L et al: Diffuse-type tenosynovial giant cell tumor in association with neurofibromatosis type 1-Noonan syndrome: possibly more than a chance relationship. Am J Surg Pathol. 30(6):734-8, 2006
Middleton WD et al: Giant cell tumors of the tendon sheath: analysis of sonographic findings. AJR Am J Roentgenol. 183(2):337-9, 2004
Aoki J et al: FDG-PET for preoperative differential diagnosis between benign and malignant soft tissue masses. Skeletal Radiol. 32(3):133-8, 2003
Kitagawa Y et al: MR imaging for preoperative diagnosis and assessment of local tumor extent on localized giant cell tumor of tendon sheath. Skeletal Radiol. 32(11):633-8, 2003
Giant cell tumor of tendon sheath; nodular tenosynovitis
No longer recommended: extraarticular pigmented villonodular synovitis (PVNS)
Definitions
TSGCT: group of lesions most often arising from synovium of joints, bursae, and tendon sheaths, which demonstrates synovial differentiation
Similar pathologic entity to what formerly was referred to as PVNS
Usually divided according to site (intra- vs. extraarticular) and growth pattern (localized vs. diffuse)
Diffuse: most intraarticular; rarely extraarticular
Localized: intraarticular at knee (focal nodular synovitis) and extraarticular lesions
Tenosynovial Giant Cell Tumor, Extraarticular
Uncommon, rarely metastasizing fibrohistiocytic tumor representing extraarticular soft tissue form of TSGCT
Malignant Tenosynovial Giant Cell Tumor
De novo or transformation after multiple recurrences
Prevalence of malignant transformation of TSGCT is ~ 3%
IMAGING
General Features
Radiographic Findings
MR Findings
Imaging Recommendations
Ultrasonographic Findings
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Bernthal NM et al: The diffuse-type tenosynovial giant cell tumor (dt-TGCT) patient journey: a prospective multicenter study. Orphanet J Rare Dis. 16(1):191, 2021
Ota T et al: Tumor location and type affect local recurrence and joint damage in tenosynovial giant cell tumor: a multi-center study. Sci Rep. 11(1):17384, 2021
De Saint Aubain Somerhausen N et al: Tenosynovial giant cell tumor. In Fletcher CDM et al: WHO Classification of Tumours: Soft Tissue and Bone Tumours. 5th ed. IARC Press. 133-6, 2020
Brahmi M et al: Long term term follow-up of tyrosine kinase inhibitors treatments in inoperable or relapsing diffuse type tenosynovial giant cell tumors (dTGCT). PLoS One. 15(5):e0233046, 2020
Savvidou OD et al: Extra-articular diffuse giant cell tumor of the tendon sheath: a report of 2 cases. Arch Bone Jt Surg. 4(3):273-6, 2016
Righi A et al: Metastasizing tenosynovial giant cell tumour, diffuse type/pigmented villonodular synovitis. Clin Sarcoma Res. 5:15, 2015
Palmerini E et al: Tenosynovial giant cell tumour/pigmented villonodular synovitis: outcome of 294 patients before the era of kinase inhibitors. Eur J Cancer. 51(2):210-7, 2014
Kransdorf MJ et al: Fibrous and fibrohistiocytic tumors and synovial tumors. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 3rd ed. Lippincott Williams & Wilkins. 330, 462-9, 2014
Bancroft LW et al: Imaging of benign soft tissue tumors. Semin Musculoskelet Radiol. 17(2):156-67, 2013
Zeinstra JS et al: Multifocal giant cell tumor of the tendon sheath: case report and literature review. Skeletal Radiol. 42(3):447-50, 2013
Fotiadis E et al: Giant cell tumour of tendon sheath of the digits. A systematic review. Hand (N Y). 6(3):244-9, 2011
Walker EA et al: Magnetic resonance imaging of benign soft tissue neoplasms in adults. Radiol Clin North Am. 49(6):1197-217, vi, 2011
Pallas A et al: Intense FDG uptake in an intra-articular localized giant-cell tumor of the tendon sheath (pigmented villonodular synovitis) mimics metastatic melanoma. Radiol Case Rep. 4(4):343, 2009
Bancroft LW et al: Imaging of soft tissue lesions of the foot and ankle. Radiol Clin North Am. 46(6):1093-103, vii, 2008
Weiss SW et al: Benign tumors and tumor-like lesions of synovial tissue. In Weiss SW et al: Enzinger and Weiss' Soft Tissue Tumors. 5th ed. Elsevier. 770-7, 2008
Sanghvi DA et al: Diffuse-type giant cell tumor of the subcutaneous thigh. Skeletal Radiol. 36(4):327-30, 2007
Posligua L et al: Diffuse-type tenosynovial giant cell tumor in association with neurofibromatosis type 1-Noonan syndrome: possibly more than a chance relationship. Am J Surg Pathol. 30(6):734-8, 2006
Middleton WD et al: Giant cell tumors of the tendon sheath: analysis of sonographic findings. AJR Am J Roentgenol. 183(2):337-9, 2004
Aoki J et al: FDG-PET for preoperative differential diagnosis between benign and malignant soft tissue masses. Skeletal Radiol. 32(3):133-8, 2003
Kitagawa Y et al: MR imaging for preoperative diagnosis and assessment of local tumor extent on localized giant cell tumor of tendon sheath. Skeletal Radiol. 32(11):633-8, 2003