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Giant Cell Tumor of Third Metacarpal: A Rare Case Report and Review of Literature.
J Orthop Case Rep. 2020; 9(6):11-14.JO

Abstract

Introduction

Giant cell tumor (GCT) or osteoclastoma is an osteolytic, mostly benign but locally aggressive tumor occurring in young adults at the meta-epiphyseal region of long bones such as lower end of the femur, upper end of the tibia, and lower end of the radius, and proximal humerus in descending order of frequency. Only 2% of all GCT of bone occur in hand. GCT of metacarpal (MC) has different characteristics than that of other long bones. It has more aggressive behavior with involvement of entire length of MC with soft tissue extension.

Case Report

We are reporting a case of GCT of the 3rdMC in a 19-year-old female. She presented to us with a painful, firm, ovoid, and gradually progressive swelling measuring 4 cm × 3 cm over the dorsum of the left (non-dominant)hand, since past 6 months. Fine-needle aspiration cytology was suggestive of GCT of the tendon sheath. Pre-operative magnetic resonance imaging and computed tomography scan revealed the extent of the lesion with no neurovascular involvement. Although various reconstructive procedures to salvage the affected Ray have been reported in literature, we planned for a surgical resection of the lesion leaving behind 1 cm of healthy MC base which appeared to be normal radiologically and intraoperatively. Reconstruction of the defect was done using non-vascularized contoured fibular strut graft, fixed with 2.5 mm mini reconstruction plate, along with reconstruction of the collateral ligaments of the metacarpophalangeal joint. The histopathological study confirmed the diagnosis of GCT.

Conclusion

GCT of hand is a rare tumor, due to its relatively more aggressive behavior and high chance of recurrence it, nevertheless, provokes quite difficult issue to solve. Prognosis, treatment, and results are directly dependent on early diagnosis and adequate therapy.

Authors+Show Affiliations

Department of Orthopaedics, Apollo Hospital, Bhubaneswar, Odisha, India.Department of Orthopaedics, Apollo Hospital, Bhubaneswar, Odisha, India.Department of Orthopaedics, Apollo Hospital, Bhubaneswar, Odisha, India.Department of Orthopaedics, Apollo Hospital, Bhubaneswar, Odisha, India.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32548019

Citation

Gachhayat, Ashok Kumar, et al. "Giant Cell Tumor of Third Metacarpal: a Rare Case Report and Review of Literature." Journal of Orthopaedic Case Reports, vol. 9, no. 6, 2020, pp. 11-14.
Gachhayat AK, Patnaik S, Sahoo AK, et al. Giant Cell Tumor of Third Metacarpal: A Rare Case Report and Review of Literature. J Orthop Case Rep. 2020;9(6):11-14.
Gachhayat, A. K., Patnaik, S., Sahoo, A. K., & Karthik, R. R. (2020). Giant Cell Tumor of Third Metacarpal: A Rare Case Report and Review of Literature. Journal of Orthopaedic Case Reports, 9(6), 11-14. https://doi.org/10.13107/jocr.2019.v09.i06.1566
Gachhayat AK, et al. Giant Cell Tumor of Third Metacarpal: a Rare Case Report and Review of Literature. J Orthop Case Rep. 2020;9(6):11-14. PubMed PMID: 32548019.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Giant Cell Tumor of Third Metacarpal: A Rare Case Report and Review of Literature. AU - Gachhayat,Ashok Kumar, AU - Patnaik,Sanjeev, AU - Sahoo,Akshaya Kumar, AU - Karthik,R R, PY - 2020/6/18/entrez PY - 2020/6/18/pubmed PY - 2020/6/18/medline KW - 2.5mm mini reconstruction plate KW - 3rd metacarpal KW - Giant cell tumor KW - fibular strut graft KW - surgical resection SP - 11 EP - 14 JF - Journal of orthopaedic case reports JO - J Orthop Case Rep VL - 9 IS - 6 N2 - Introduction: Giant cell tumor (GCT) or osteoclastoma is an osteolytic, mostly benign but locally aggressive tumor occurring in young adults at the meta-epiphyseal region of long bones such as lower end of the femur, upper end of the tibia, and lower end of the radius, and proximal humerus in descending order of frequency. Only 2% of all GCT of bone occur in hand. GCT of metacarpal (MC) has different characteristics than that of other long bones. It has more aggressive behavior with involvement of entire length of MC with soft tissue extension. Case Report: We are reporting a case of GCT of the 3rdMC in a 19-year-old female. She presented to us with a painful, firm, ovoid, and gradually progressive swelling measuring 4 cm × 3 cm over the dorsum of the left (non-dominant)hand, since past 6 months. Fine-needle aspiration cytology was suggestive of GCT of the tendon sheath. Pre-operative magnetic resonance imaging and computed tomography scan revealed the extent of the lesion with no neurovascular involvement. Although various reconstructive procedures to salvage the affected Ray have been reported in literature, we planned for a surgical resection of the lesion leaving behind 1 cm of healthy MC base which appeared to be normal radiologically and intraoperatively. Reconstruction of the defect was done using non-vascularized contoured fibular strut graft, fixed with 2.5 mm mini reconstruction plate, along with reconstruction of the collateral ligaments of the metacarpophalangeal joint. The histopathological study confirmed the diagnosis of GCT. Conclusion: GCT of hand is a rare tumor, due to its relatively more aggressive behavior and high chance of recurrence it, nevertheless, provokes quite difficult issue to solve. Prognosis, treatment, and results are directly dependent on early diagnosis and adequate therapy. SN - 2250-0685 UR - https://www.unboundmedicine.com/medline/citation/32548019/Giant_Cell_Tumor_of_Third_Metacarpal:_A_Rare_Case_Report_and_Review_of_Literature L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32548019/ DB - PRIME DP - Unbound Medicine ER -
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