Recurrent giant cell tumors of the tendon sheath

Seventy patients underwent surgical excision of a giant cell tumor of the tendon sheath. The patients were monitored for an average of 3 years 4 months. Nineteen of the 70 patients (27%) had a surgically and histologically documented recurrence at an average of 2 years 3 months (range, 3 months to 10 years) following the initial procedure. Eight of 19 patients (42%) with recurrence had a prior recurrence. Statistically significant risk factors for recurrence included presence of adjacent degenerative joint disease, location at the distal interphalangeal joint of the finger or interphalangeal joint of the thumb, and radiographic presence of an osseous pressure erosion. Age, gender, size, and location within the digit (volar vs. dorsal) were not risk factors for recurrence. Awareness of these associations should be reflected in the surgeon's approach and preoperative discussion with the patient.