Abstract:

Objective To explore imaging features of diffuse giant cell tumor of tendon sheath （D-GCTTS） in large joints. Methods Imaging data were retrospectively analyzed for 11 patients with D-GCTTS in large joints，which was confirmed based on pathology analysis of surgical samples. All patients were examined by X-ray and MRI；7 were also examined by CT. Results X-ray examination revealed a mass of slightly elevated density close to joint soft tissue and muscle；7 cases showed well-defined subarticular bone destruction. The soft tissue mass and bone destruction in 7 patients was clearer by CT than by X-ray；CT also revealed cross-articular bone destruction，edge osteosclerosis，and absence of calcification within the soft tissue mass. Lesion extent in 9 cases was clearer by MRI than by CT；MRI revealed that the soft tissue mass in 9 cases was well-defined，parosteal and para-articular，lobulated，and slug，and that it showed inhomogeneous low signal in each sequence. Lesions in 6 cases showed moderate or obvious heterogeneous enhancement，and 7 cases showed bone destruction. The signal in the bone destruction zone was consistent with the soft tissue mass. Joint effusion was detected in 2 cases. Conclusion It may be possible to reliably diagnose D-GCTTS in large joints based on the detection of bone destruction by X-ray and CT as well as double low signal by MRI.

Key words: Soft tissue neoplasm, Diffuse giant cell tumor of tendon sheath, Tomography, X-rays, Magnetic resonance imaging, Diagnosis