Giant cell tumor of the bones of the hand and foot

BACKGROUND Giant cell tumor of the small bones of the hand and foot is suspected of having some peculiar features compared with giant cell tumor in other sites. Moreover, it could share some features with other giant cell rich lesions involving the hand and foot, and this may affect the differential diagnosis. The aim of this study was to analyze the features of lesions such as these in the files of the Rizzoli Orthopedic Institute. METHODS The incidence of giant cell tumors of the bones of the hand and foot seen at the Rizzoli Orthopedic Institute over 50 years (1947–1997) was taken into consideration. There were 8 lesions of the hand and 21 of the foot. Clinical information and follow‐up of the patients were studied and updated. Radiographs were studied and radiographic features analyzed. Histopathologic material was thoroughly reviewed and histologic features analyzed. RESULTS Although the location of tumor was helpful information, radiographic features were not specific. Giant cell tumors of the small bones of the hand and foot showed a predominance in females, younger patients and more aggressive behavior than giant cell tumors of large bones. The authors did not observe multicentricity or pulmonary metastases. CONCLUSIONS Because the radiographic features of giant cell tumor of the hand and foot overlap those of other giant cell rich lesions in these locations, histologic diagnosis is mandatory, although it may be difficult and require the establishment of diagnostic criteria for giant cell tumor. As this tumor tends to be more aggressive than other giant cell rich lesions, treatments of choice are aggressive curettage or resection. Cancer 2000;88:2022–32. © 2000 American Cancer Society. This report of the experience of the Rizzoli Orthopedic Institute with 29 patients who had giant cell tumors of the bones of the hand and foot confirms the predominance of such tumors in females and patients of younger age and the more aggressive behavior compared with giant cell tumors in other locations. Radiographic overlapping is common in giant cell rich lesions of the bones of the hand and foot, and histology is the most important diagnostic tool.