Yoon Mi Lee MD, Presenter: Nothing to Disclose

Sang Hoon Lee, Abstract Co-Author: Nothing to Disclose

Hye Won Chung MD, Abstract Co-Author: Nothing to Disclose

Myung Jin Shin, Abstract Co-Author: Nothing to Disclose

To evaluate the possibility of discriminating giant cell tumors of tendon sheath (GCTTS) from ganglion cysts in hands and feet by analysis of sonographic findings.

A retrospective review was performed of consecutive 56 patients (M:F=18:38, mean age: 36 years) who were examined with sonography and pathologically confirmed with GCTTS in hands and feet from 1999 to 2008. The sonographic findings were compared with those of consecutive 50 patients (M:F=18:32, mean age: 45 years) with pathologially proven ganglion cysts during recent 3 years. We evaluated the sonographic features paying special attention to the following points: predilection site (each 3 parts in hands and feet, dorsal or volar), maximal length, echotexture (anechoic, hypoechoic, mixed hypoechoic, and isoechoic), internal vascularity (abscent or present), adjacent bone erosion (abscent or present). The statistical analysis was performed with t-test, chi-square test and Wilcoxon rank sum test.

GCTTS were located most frequently in finger (66%), toe (10.7%), wrist (8.9%), midfoot and metatarsal level (5.4%), hindfoot (5.4%), and metacarpal level (3.6%) in order. The predilection sites of ganglion cysts were wrist (40%), and followed by finger (24%), midfoot and metatarsal level (16%), hindfoot (12%), and metacarpal level (8%). In cases of GCTTS, volar side (60.7%) involved more frequently than doral side (39.3%). The mean maximal lengths of GCTTS and ganglion cysts were 1.76 ± 0.86 and 1.45 ± 0.79cm, respectively (p>0.05). The GCTTS/ganglion cysts showed anechogenicity 0/42, hypoechogenicity 17/4, mixed hypoechogenicity 36/4, and isoechogenicity 3/0 (p<0.01). Twenty one (37.5%) of GCTTS had internal vascularity on doppler images and 12 (21.4%) showed adjacent bone erosion, but none of them were present in ganglion cysts (p<0.05).

GCTTS were characterized by hypoechogenicity, internal vascularity, and adjacent bone erosion. Therefore, it is easy to differentiate between GCTTS and ganglion cysts by analyzing the sonographic features.

GCTTS can only be treated with resection, but ganglion cysts can be treated with non-surgical methods. Distinguishing between GCTTS and ganglion cysts on sonography is useful in treatment planning.

Lee, Y, Lee, S, Chung, H, Shin, M, Is It Easy to Differentiate between Giant Cell Tumors of the Tendon Sheath and Ganglion Cysts in Hands and Feet on Sonography?.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8011862.html