Giant Cell Tumour of the Tendon Sheath of the Hand: A Retrospective Review With Recurrence Risk Analysis

Introduction: Giant cell tumours of the tendon sheath (GCT-TS) are a benign but potentially recurrent soft tissue tumour of the hand. It typically presents as a slow-growing, painless mass and is most frequently located on the volar aspect of the fingers. Despite its benign nature, recurrence rates vary widely across published series. Methods: This retrospective study analysed 90 histologically confirmed cases of GCT-TS treated surgically between 2011 and 2023 in a single orthopaedic surgery department. Demographic, clinical, imaging, and histological data were collected. A phone survey was conducted to assess long-term outcomes and possible recurrence. In cases of suspected recurrence, in-person evaluation was offered. Results: A total of 85 patients (51 female, 34 male) were included, with a mean age of 50 years. The index finger was the most commonly affected location (31.8%), and the average lesion size was 17.6 mm. No atypical histological features were found. The recurrence rate confirmed by histology was 5.6% (n = 5), increasing to 10% (n = 9) when including clinically suspected cases. Statistical analysis revealed a significant association between recurrence and lesion location, with all recurrences occurring in finger joints (p = 0.013). Multivariable analysis confirmed joint-related location as an independent risk factor (odds ratio (OR) = 0.09; 95% confidence interval (CI): 0.01-0.80; p = 0.026). Post-operative complications were minimal, and patient satisfaction was high. Conclusion: Our findings show a recurrence rate at the lower end of published data. Lesions involving finger joints were significantly more likely to recur. Pre-operative imaging and meticulous surgical technique are crucial to minimise recurrence and optimise outcomes.