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Growing wrist mass.

W C Peh1, T W Shek, W Y Ip

  • 1Department of Diagnostic Radiology, Singapore General Hospital, Singapore. gdrpcg@sgh.gov.sg

Annals of the Rheumatic Diseases
|May 15, 2001
PubMed
Summary
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Giant cell tumors of the tendon sheath can present as wrist masses. Magnetic resonance imaging (MRI) is crucial for diagnosing these tumors, showing characteristic features on various sequences.

Area of Science:

  • Orthopedics
  • Radiology
  • Pathology

Background:

  • Giant cell tumors of the tendon sheath (GCTTS) are common benign soft tissue tumors.
  • They typically occur in the hands and feet, often affecting the fingers.
  • Wrist involvement is less common but can occur, presenting as a growing mass.

Observation:

  • A 46-year-old male presented with a progressively enlarging wrist mass.
  • Radiographs revealed erosions of the triquetrum and hamate bones.
  • Magnetic resonance imaging (MRI) demonstrated a solid mass originating from the extensor carpi ulnaris tendon.

Findings:

  • MRI signal characteristics included T1 hypointensity/isointensity, T2 hypointensity, and blooming on gradient echo sequences.
  • Histopathological examination of the excised mass confirmed the diagnosis of giant cell tumor of the tendon sheath.

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  • The imaging findings were consistent with the final diagnosis.

    • Implications:

    • This case highlights the importance of MRI in evaluating wrist masses.
    • Understanding the characteristic MRI features of GCTTS aids in accurate preoperative diagnosis.
    • Early and accurate diagnosis facilitates appropriate surgical management and improves patient outcomes.