Abstract
» Tenosynovial giant-cell tumor (TGCT) is the common term used to
describe a group of soft-tissue tumors that share a common etiological
link. Historically, the multiplicity of terms used to describe these
tumors, in addition to contention regarding etiology, has led to
confusion regarding their diagnosis and treatment.
» An overexpression of colony-stimulating factor-1 (CSF-1) caused by a
specific chromosomal translocation t(1;2) has been identified in both
localized and diffuse tumors and has led to an interest in pharmacological
therapies targeting the CSF-1/CSF-1R (CSF-1 receptor) axis.
» Operative treatment remains the mainstay of treatment for TGCT
of the foot and ankle; however, given the rarity of these tumors,
treatment recommendations have not been verified on the basis
of large cohort studies or high-level evidence.
» A multidisciplinary approach is important in TGCT treatment. Open
surgical excision or synovectomy is considered to be the first-line
treatment. While the roles of arthroscopic excision, radiation therapy,
and targeted pharmacological therapies have not been validated,
these therapies may be of use for selected patients, particularly those
with recurrent or unresectable lesions.
» A clear definition of tumor recurrence based on radiographic evidence
of progression and/or return of symptoms is required to quantify the
outcomes of treatment, to reduce heterogeneity between studies, and
to avoid morbidity associated with repeated surgical excisions.
describe a group of soft-tissue tumors that share a common etiological
link. Historically, the multiplicity of terms used to describe these
tumors, in addition to contention regarding etiology, has led to
confusion regarding their diagnosis and treatment.
» An overexpression of colony-stimulating factor-1 (CSF-1) caused by a
specific chromosomal translocation t(1;2) has been identified in both
localized and diffuse tumors and has led to an interest in pharmacological
therapies targeting the CSF-1/CSF-1R (CSF-1 receptor) axis.
» Operative treatment remains the mainstay of treatment for TGCT
of the foot and ankle; however, given the rarity of these tumors,
treatment recommendations have not been verified on the basis
of large cohort studies or high-level evidence.
» A multidisciplinary approach is important in TGCT treatment. Open
surgical excision or synovectomy is considered to be the first-line
treatment. While the roles of arthroscopic excision, radiation therapy,
and targeted pharmacological therapies have not been validated,
these therapies may be of use for selected patients, particularly those
with recurrent or unresectable lesions.
» A clear definition of tumor recurrence based on radiographic evidence
of progression and/or return of symptoms is required to quantify the
outcomes of treatment, to reduce heterogeneity between studies, and
to avoid morbidity associated with repeated surgical excisions.
Original language | English |
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Article number | e3 |
Pages (from-to) | 1-13 |
Number of pages | 13 |
Journal | JBJS reviews |
Volume | 5 |
Issue number | 1 |
DOIs | |
Publication status | Published - Jan 2017 |
Externally published | Yes |