23/12/2025
***A Case Of Tenosynovial Giant Cell Tumor Of The Tendon Sheath***
Clinical History:~ 45 years old male patient present with long-standing lump over the right thumb.
No pain, tenderness, discoloration, or functional limitation.
Findings:~
• At the pollex, adjacent to the joint space, an oval-shaped solid lesion is noted in the soft tissues.
• The lesion is hypoechoic, well defined, with mildly opacified / slightly lobulated margins.
• Located close to the joint space and tendon sheath.
• Posterior acoustic enhancement is seen, likely related to the adjacent joint or dense tissue interface.
• No definite internal cystic component, calcification, or liquefaction noted.
• Color Doppler shows no significant internal vascularity.
• Underlying bone cortex appears intact, with no erosion.
• Surrounding soft tissues are unremarkable.
Impression:~ A oval-shaped hypoechoic solid mass at the right thumb near the joint space, likely representing an epidermal inclusion cyst; tenosynovial giant cell tumor of the tendon sheath is a close differential.
Other differentials:~
• Fibroma of tendon sheath
• Glomus tumor (less likely given painless, long-standing nature)
Recommendations:~
• Clinical correlation advised.
• MRI of the right thumb may be considered for further tissue characterization and pre-operative planning, if required.
• Orthopedic / Surgeon opinion for definitive management.
