Tenosynovial giant cell tumor: A retrospective analysis of clinical and imaging findings

Objectives: Tenosynovial giant cell tumor (TSGCT) is a rare proliferative synovial disorder that can lead to progressive joint destruction if diagnosis is delayed. This study describes the demographic, clinical, imaging, and therapeutic characteristics of TSGCT at a tertiary care center. Methods: This retrospective case series included 33 patients with histopathologically confirmed TSGCT. Demographic data, clinical presentation, diagnostic delay, imaging findings, treatment strategies, and recurrence rates were analyzed. Magnetic resonance imaging (MRI) findings, including bone erosions, were reviewed. Recurrence was defined by clinical symptoms with radiologic and/or pathologic confirmation. Results: Among 33 patients (60.6% female; mean age 36 years), MRI demonstrated characteristic low-signal-intensity lesions on T1/T2-weighted sequences in 93.9% of cases; blooming artifacts on gradient-echo sequences were identified in all 21 patients who underwent gradient-echo (63.6% of the cohort). The mean diagnostic delay was 17 months. Synovectomy alone was performed in 75.8% of patients; 24.2% required combined synovectomy and arthroplasty, primarily for hip disease with advanced bone erosion. Recurrence occurred in 15.2% at a mean follow-up of 24 months; all recurrent cases received adjuvant radiotherapy. Conclusion: TSGCT remains a diagnostic challenge due to a non-specific clinical presentation. MRI is pivotal for disease characterization, assessment of osseous involvement, and surgical planning. Early recognition and individualized management may improve outcomes and reduce morbidity.