International Journal of Research & Review (www.ijrrjournal.com) 9 Vol.5; Issue: 1; January 2018 International Journal of Research and Review www.ijrrjournal.com E-ISSN: 2349-9788; P-ISSN: 2454-2237 Case Report Giant Cell Tumor of the Extensor Tendon Sheath in Proximal Phalanx- A Case Report Akshay Bhardwaj 1 , Ashok Patil 2 , Vaijnath Rahate 2 , Gaurav Sharma 3 1 Senior Resident, Dept of Orthopedics, DDU Hospital, New Delhi 2 Professor, Dept of Orthopaedics, Islampur-Sangli Road, Tal-Walwa, Sangli, UrunIslampur, Maharashtra-415409. 3 Assistant Professor, Dept of Orthopaedics, Islampur-Sangli Road, Tal-Walwa, Sangli, UrunIslampur, Maharashtra - 415409. Corresponding Author: Gaurav Sharma ABSTRACT Multilobulated giant cell tumors affecting the extensor tendon sheaths in hand are uncommon lesions. The treatment of these lesions includes a wide marginal excision. We report a case of giant cell tumor involving the extensor sheath of proximal phalanx which was treated with wide local excision. The patient showed no signs of recurrence at one year follow-up. Keywords- Tendon sheath, Giant cell tumor, proximal phalanx. INTRODUCTION Giant cell tumors are slow growing benign soft tissue tumors which can arise from the synovium, tendon sheath or even bursae. [1,2] They are the second most common tumor of the hand after synovial cysts with a female preponderance affecting the age group between 30 and 50 years of age. [1,3,4] Albeit it has a propensity towards palmar aspect of hand, it can also affect knee, foot, ankle, elbow or even hip. [5] The treatment usually involves local excision; however, recurrence rates as high as 44% have been reported. [5,6] We report a case of bilobular giant cell tumor affecting the extensor tendon sheath of proximal phalanx treated by wide local excision. CASE REPORT A 50 year old right hand dominant female presented to us with complaints of painless progressively increasing swelling over proximal phalanx of left middle finger since past 6 months. On examination, there was a firm in consistency, non-tender swelling measuring 2 x 2 cms in size extending to the dorso- medial aspect of proximal phalanx of middle finger. The swelling was adherent to the skin with no restriction at proximal inter-phalangeal joint. There were no signs of infection or neoplasm. Orthogonal radiographs of left hand showed a soft tissue shadow around the medial and dorsal aspect of proximal phalanx with no joint involvement (Fig.1 and Fig.2 ). Ultrasonography was further done to determine the pathology which showed two homogenous hypoechoic swellings with solid consistency just beside the extensor tendon and not involving it. A suspicion of a benign tumor was made and thus a decision to excise the swelling was made. The patient