Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2022; 10(29): 10763-10771
Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10763
Malignant giant cell tumors of the tendon sheath of the right hip: A case report
Wen-Peng Huang, Ge Gao, Qi Yang, Zhao Chen, Yong-Kang Qiu, Jian-Bo Gao, Lei Kang
Wen-Peng Huang, Qi Yang, Zhao Chen, Yong-Kang Qiu, Lei Kang, Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China
Ge Gao, Department of Medical Imaging, Peking University First Hospital, Beijing 100034, China
Jian-Bo Gao, Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Author contributions: Huang WP and Gao G contributed equally to this work; Huang WP, Gao G, Yang Q, Chen Z, and Qiu YK designed research; Huang WP, Gao G, Kang L and Gao JB performed research; Huang WP, Gao G and Kang L analyzed data; and Huang WP, Gao G and Kang L wrote the paper.
Supported by The Beijing Science Foundation for Distinguished Young Scholars, No. JQ21025.
Informed consent statement: Written informed consent for publication of clinical details and/or clinical images was obtained from the parents of the participant. A copy of the consent form is available for review by the Editor of the journal.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Lei Kang, MD, PhD, Department of Nuclear Medicine, Peking University First Hospital, No. 8 Xishiku Street, Xicheng Dist., Beijing 100034, China.
Received: June 14, 2022
Peer-review started: June 14, 2022
First decision: July 29, 2022
Revised: August 9, 2022
Accepted: August 30, 2022
Article in press: August 30, 2022
Published online: October 16, 2022

Malignant giant cell tumor of the tendon sheath (MGCTTS) is an extremely rare malignant tumor originating from synovial and tendon sheath tissue with highly aggressive biological behavior and a high rate of local recurrence and distant metastasis which should be considered a highly malignant sarcoma and managed aggressively. How to systemically treat MGCTTS remains a challenge. In this case, a patient with MGCTTS suffered a recurrence after 2 surgical resections received adjuvant chemotherapy and radiation therapy, but the treatment outcome remained poor. More clinical trials and better understanding of the biology and molecular aspects of this subtype of sarcoma are needed while novel medicines should be developed to efficiently target particular pathways.


A 52-year-old man presented with persistent dull pain in the right groin accompanied by limited right hip motion starting 6 mo ago. Two months before his attending to hospital, the patient's pain worsened, presenting as severe pain when standing or walking, limping, and inability to straighten or move the right lower extremity. Surgical excision was performed and MGCTTS was confirmed by pathology examination. Two recurrences occurred after surgical resection, moreover, the treatment outcome remained poor after adjuvant chemotherapy and radiation therapy. The patient died only 10 mo after the initial diagnosis.


MGCTTS is characterized by a joint mass with pain and limited motion. It typically grows along the tendons and infiltrated into the surrounding muscle and bone tissue, with a stubborn tendency to relapse, as well as pulmonary metastasis. Radically surgical resection provides a choice of treatment whereas post-operation care should be taken to preserve the function of the joint. Chemotherapy and radiotherapy can be used as alternative treatments when radical resection cannot be performed.

Keywords: Malignant, Tenosynovial giant cell tumor, Recurrence, Magnetic resonance imaging, Bone scintigraphy, Treatment, X-ray computed tomography, Case report

Core Tip: This case demonstrates the highly aggressive biological behavior of Malignant giant cell tumor of the tendon sheath (MGCTTS), which mostly appears in Computed tomography (CT) images as a large mass that grows around the joint with poorly defined borders. CT can show details of bone destruction surrounding the lesion caused by extensive invasion. Magnetic resonance imaging clearly shows the histological features of the tumor and its relationship to the surrounding tissue. There is a stubborn tendency for MGCTTS to relapse and a possibility of pulmonary metastasis. Postoperative follow-up, especially long-term follow-up for evaluating recurrence, is necessary. Meanwhile systemic examination should be undertaken to evaluate distant metastasis.