Corresponding author: Konstantinos Skarentzos, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece; Email:
The aim of this study was to report a rare case of a giant cell tumor of the patellar tendon sheath. This indicates the diagnostic procedures and treatment options for giant cell tumors of the patellar tendon. This study reported a case of a 13-year-old male patient with a giant cell tumor of the tendon sheath. In our case, open arthrotomy was performed with complete surgical excision of the lesion. Histopathological examination revealed a giant cell tumor. At the last follow-up, 2 years after surgery, no complications were reported. The giant cell tumor of the patellar tendon sheath is an uncommon benign tumor. It mimics common knee symptoms. A differential diagnosis is definitely a challenge. Available operation approaches have demonstrated similar results, which lead to symptom relief and a low recurrence rate.
Skarentzos K, Panteli D, Moustafa RM, Tottas S, Kougioumtzis IE, Drosos GI. Giant cell tumor of the patellar tendon sheath in childhood: case report. Folia Med (Plovdiv) 2023;65(2):301-304. doi:
The WHO classified two types of giant cell lesions originating from the tendon and synovium. Giant cell tumors of the patellar tendon sheath (GCT-TS) can be classified as localized (L-) or diffuse (D-) type. L-GCT-TS initially occurs in the tendon sheaths of the hand and foot and is characterized by a nodular mass. In comparison, D-GCT-TS occurs in large joints with increased growth and recurrence rates. It is common for the knee joint to invade the outer part of the joint capsule. The prevalence of GCTs is 1/50,000 per population. Females tend to be affected 1.6 times more than males. Tissues around the knee were affected in only 2 of 71 patients in the study by Monaghan et al.[
The exact etiology of GCTTS remains unknown. Clinical characteristics are proportional to the location; however, differential diagnosis remains challenging. The predominant symptom is painless soft tissue masses, accompanied by discomfort, swelling, and restriction of the range of motion.[
The aim of this study was to report a rare case of GCT-TS of the patellar tendon. This indicates the diagnostic procedures and treatment options for GCT-TS of the patellar tendon.
T-2 weighted MR1, coronal and sagittal planes, depicting the giant cell tumor of the patellar tendon sheath.
The excised lesion of the giant cell tumor.
The patellar tendon is considered a rare location for manifestation of GCTTS. This condition is mostly localized in the hands (93%) and rarely around the knee (2.82%). The mean age at presentation is 46.3 years.[
The most predominant symptom is a painless soft-tissue mass, accompanied by pain, swelling, and ROM limitation.[
Surgical treatment involves an assorted approach. Abdullah et al. treated a patient with arthrotomy.[
Histopathological examination confirmed the diagnosis after tumor excision. Typically, the tumor is soft, slightly brownish, or reddish-tan. Common findings include yellow and white areas due to xanthomatous changes and fibrous tissue. Microscopical elements are addressed into distinction of forms including the presence of foam cells, multinucleated giant cells, stromal cells with or without hemosiderin deposits and collagen.[
Open arthrotomy and arthroscopic recession are considered acceptable treatment options. According to the cases, both interventions showed similar results. Moreover, they showed no complications, pain relief, or ROM recovery. Minimally invasive approaches, such as arthroscopy, allow for the effective examination of all compartments of the knee with compelling excision of the lesion. The recurrence rate is independent of mitotic activity and incomplete resection. [
GCT-TS is an uncommon benign tumor. It mimics common knee symptoms. A differential diagnosis is definitely a challenge. It is crucial to indicate patient history, meticulous clinical examination, and cutting-edge imaging techniques; however, the definitive diagnosis is confirmed by histopathological examination. Available operation approaches have demonstrated similar results, which lead to symptom relief and a low recurrence rate.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Written consent was obtained from all the patients.
All authors have declared no conflict of interest.