Histological characteristics of a giant cell tumor of the tendon sheaths associated with palmar fascial fibromatosis (case report)

Abstract

Giant cell tumor of the tendon sheaths and palmar fascial fibromatosis are both fibrohistiocytic diseases. There is no information about their combination in the available literature. Aim To analyze the histological characteristics of a giant cell tumor of the tendon sheath associated with palmar fascial fibromatosis. Materials and methods Case history and pathomorphological examination of the surgical material of patient M with recurrent palmar fascial fibromatosis and Dupuytren's contracture of the 5th ray of the right hand in grade 3 and a neoplasm of the 2nd finger of the right hand Results A neoplasm with a thin fibrous capsule, permeated with blood vessels, many of them had abnormally thickened fibrous walls and completely obliterated lumens. The cellular composition of the tumor is mixed: fibroblast-like cells, small histiocytes, siderophages, osteoclast-like giant multinucleated cells, xanthoma and plasma cells. The frequency of mitoses is less than one per 10 fields of view, apoptotic bodies from zero to several per field of view. In the composition of fibromatous cords in the projection of the V beam, giant multinucleated cells (possibly cells of foreign bodies) were found. Conclusion For the first time, a clinical case of a giant cell tumor of the tendon sheaths, which developed against the background of a long-term recurrent palmar fascial fibromatosis, is presented. Taking into account the pathomorphological characteristics of the surgical material, the risk of its recurrence and malignancy in patient M. is low. However, the unpredictability of the histogenesis of this tumor known from the literature is an indication for active clinical observation.

Keywords

• palmar fascial fibromatosis
• dupuytren's contracture
• giant cell tumor of the tendon sheath
• pathohistology