Wide-margin excision of diffuse ankle's tendon sheath giant cell tumor in 24 patients: A mid-term study

Giant cell tumour of tendon sheath (TSGCT) is an uncommon soft tissue tumor, especially in its diffuse subtype (D-TSGCT), which is rare and associated with a high recurrence rate after treatment. This condition significantly affects joint function and quality of life. This retrospective study evaluated the clinical characteristics, surgical outcomes, and long-term follow-up of 24 patients who underwent wide-margin resection for ankle D-TSGCT from 2011 to 2018. The average patient age was 36.5 years, with common symptoms including palpable masses and ankle swelling. All patients received wide-margin resection, with a mean follow-up period of 75.7 months. Tumor recurrence occurred in five patients (21 %), with complications included postoperative infections, surgical site pain, ankle instability, and stiffness. There was a significant improvement in the Musculoskeletal Tumor Society (MSTS) scores post-surgery. Additionally, the Foot and Ankle Ability Measure (FAAM) showed improvements in daily living and physical activities, though Ankle Joint Functional Assessment Tool (AJFAT) scores did not demonstrate significant change. These findings indicate that wide-margin resection is an effective treatment for D-TSGCT, preserving ankle function and demonstrating a low recurrence rate, although it may lead to ankle instability requiring careful postoperative monitoring and rehabilitation.