Background and Objectives: Giant cell tumor of the tendon sheath (GCTT
S) is a lesion of uncertain etiology. To better interpret pathogenesis
and aid in the differentiation of GCTTS from other similar pathologic
al processes we reviewed the literature and analyzed the available inf
ormation. Methods: We retrospectively studied clinicopathologic findin
gs in 28 cases of GCTTS on the basis of anatomic location and histolog
ic appearance of the lesion. Results: The GCTTS could be divided into
those involving the common digits (20 cases) and larger joint group (8
cases) based on anatomic location. Grossly the digit tumors were smal
l, multiple, surrounded by a thin fibrous capsule, and had a variegate
d appearance, while the large joint tumors were relatively large and c
overed by one or more layers of synovium. Microscopically both groups
consisted of a mixture of round to polygonal histiocytes, foam cells,
hemosiderin laden macrophages, and multinucleated giant cells, The gia
nt cells seemed more abundant in the digit tumors, while the pseudogla
ndular spaces lined by synovial cells were more striking in the large
joint group. Conclusions: Local excision was the treatment of choice i
n the majority of the patients. Eight patients had local recurrence. (
C) 1998 Wiley-Liss, Inc.