Recurrent diffuse tenosynovial giant cell tumour of knee joint with emphasis on treatment trends: a case report

Abstract

Introduction: Tenosynovial giant cell tumor is a benign lesion that frequently recurs locally. The recurrence rate is quite high for diffuse tenosynovial giant cells. Complete surgical excision remains the standard of treatment, yet radiotherapy can be delivered in cases of recurrence. Here we present a case of recurrent diffuse tenosynovial giant cell treated with Image Guided-Intensity modulated radiotherapy. The case report also highlights and discusses other potential treatment options available or under investigation.

Case presentation: A 32-year-old female presented to us as a recurrent case of Diffuse tenosynovial giant cell tumor (DTGCT).  She was offered above-knee amputation, which she refused. The role of systemic therapy was explored. She was taken for Image-guided; intensity-modulated radiotherapy (IG-IMRT).

Discussion: DTGCT shows a widespread morphological spectrum. Though Surgery remains the standard of care, Post op radiotherapy can be delivered in incomplete synovectomy or recurrence cases. The potential use of agents targeting CSF1/ CSF1R in D-TGCT has been explored.

Conclusion: Post operative radiotherapy with advanced External beam radiation therapy techniques IG-IMRT, after surgery produced acceptable functional status and excellent local control with few side effects. Our patient post radiotherapy phase was uneventful. His 6-month evaluation was suggestive of no recurrence.