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a SciTechnol journal Case Report Asuquo et al., J Clin Exp Oncol 2013, 2:3 http://dx.doi.org/10.4172/2324-9110.1000110 Journal of Clinical & Experimental Oncology All articles published in Journal of Clinical & Experimental Oncology are the property of SciTechnol, and is protected by copyright laws. Copyright © 2013, SciTechnol, All Rights Reserved. International Publisher of Science, Technology and Medicine Giant Cell Tumour of Soft Tissue of the Finger: A Case Report ME Asuquo 1 *, VI Nwagbara 1 , C Agbor 1 , S Akpan 1 , G Ebughe 2 and T Ugbem 2 Abstract Giant cell tumour of soft tissue resembling osseous giant cell tumour is a distinct and uncommon entity. Presented is a 52-year- old man with a 3-year history of swelling located on the dorsum of the right middle finger diagnosed on histology as giant cell tumour of soft tissue. The need for high index of suspicion by physicians is emphasized, as giant cell tumour of soft tissue should be considered as differential diagnosis of finger lumps. Keywords Giant cells; Soft tissue *Corresponding author: ME Asuquo, Department of Surgery, University of Calabar Teaching Hospital, Calabar, Nigeria, GPO Box 1891, Calabar, 540001, Nigeria, E-mail: [email protected] Received: February 27, 2013 Accepted: April 12, 2013 Published: April 19, 2013 Examination revealed a middle-aged male in relative good health, afebrile, not pale. On the right hand, there was an irregular nodular mass on the dorsal surface of the right middle finger measuring 5x3 cm, non-tender, firm, mobile and not attached to the skin and underlying structures. ere was no regional lymphadenopathy (Figure 1). Haemogram and urinalysis were unremarkable. Plain X-ray of the right hand showed a well-defined unmineralised soſt tissue mass around the proximal interphalangeal joint of the middle finger, with a normal adjoining cortex of the phalanx (Figure 2). A clinical diagnosis of a fibroma of the right middle finger was made. Marginal excision biopsy of the mass was done under a ring block. It revealed an irregular, lobulated, encapsulated mass (Figure 3). Histopathology report showed a tumour composed of proliferating uniform oval mononuclear cells in a myxoid stroma. Scattered around the background were numerous osteoclast-type giant cells having many nuclei that resemble the nuclei of mononuclear cells. No malignancy was seen, Figure 4a and 4b. A diagnosis of giant cell tumour of soſt tissue (GCT-ST) of the right middle finger was made. Follow-up in the SOPD has been satisfactory and patient informed of the need for follow up. Discussion Giant cell tumour of the soſt tissue is a primary soſt tissue neoplasm, it closely resembles GCT of bone cytomorphologically as the giant cells resemble osteoclast, however both are distinct entities [5,7], as depicted by our patient. is rare entity first described by Salm and Sissons in 1972 [3], was also described by Guccion and Enzinger later in the same year [6]. e histiogenesis of this tumour is not certain, but it is postulated that osteoclast-like cells are the result of fusion of circulating monocytes recruited into the lesion [2,8]. Giant cell tumour of soſt tissue though predominantly a benign condition, demonstrates unpredictable capacity to occasionally recur or evolve into a malignant lesion [2]. Reported recurrence rate is 6.2%, though infrequent, metastasis to the lungs and parotid glands have been described [4,5]. is underscores the need to ensure a tumour free margin post excision and follow up of patients, as the tumour biology of this lesion is not completely known. It affects mainly adults of both sexes [2], in keeping with our male patient aged 52 years. Oliveria et al. reported an age range of 5-80 years (median 43 years), [5], while Tagera-Vaquerizo et al. reported an age range of 5-84 years [8], both with no predilection for sex. is lesion, predominantly found in the lower limb with the trunk and upper limb ranking second and third respectively [5,8]. Kumar and Carter reported that the hand is rarely involved [1]. However, Chand et al. reported that the commonest site was the upper limb, finger being the most common location [2]. Our patient’s lesion was located on the dorsum of the right middle finger. In keeping with reported finger lesions, Tejera-Vaquerizo reported a distal phalanx Introduction Giant cell tumour of soſt tissue (GCT-ST) is a rare entity and has a histopathological semblance of osteoclast like multinucleated giant cells seen in the osseous counterpart [1,2]. Salm and Sisson first coined the term primary GCT-ST in 1972 [3]. It presents as a painless, firm, mobile, well-delineated mass not attached to muscle, tendon, or bone [4]. Most of the lesions are seen in the lower limb, the most common site being the thigh, followed by trunk and upper limb [5]. If surgically treated by excision with tumour free margin, it is expected to have a benign clinical course [1]. However, despite being a benign lesion, it may recur aſter excision, has the potential of malignant transformation, and rarely metastasize [6]. We report a case of GCT- ST of the dorsum of the middle finger in a 52-year-old man. Case Summary A 52-year old businessperson, who had recovered from three cerebrovascular accidents affecting the leſt cerebral hemisphere, was referred from the medical out patient department (MOPD) to the surgical out patient department (SOPD) with a 3-year history of a swelling on the right middle finger. e swelling began as a nodule 3 years ago, but gradually increased in size, becoming multilobulated. ere was no associated history of trauma or arthritis, pain or limitation of movement of the affected finger and no similar swellings in other parts of the body. He is a known hypertensive on nifedipine medication.
