Comparison of clinical and pathological characteristics between localized giant cell and fibroadenoma of tendon sheath

Objective: To explore the clinical and pathological characteristics of localized giant cell tumor of tendon sheath (L-GCTS) and fibroma of tendon sheath (FTS), and to compare and analyze them. Methods: 241 cases of L-GCTS and 41 cases of FTS who underwent surgical resection and diagnosis at Wuxi Ninth People's Hospital from 2019 to 2023 were collected. Clinical and pathological data of all cases were organized for retrospective analysis. Chi-square test was used to analyze differences between groups. Results: Comparing our two groups of cases, we found that L-GCTS is more common, while FTS is less common. However, the two were very similar in clinical features, disease course, age of onset, tumor size and overall appearance, as well as imaging manifestations; In our case, L-GCTS was more common in female patients, and there was no significant gender difference in FTS; L-GCTS was more common in the right hand, FTS was also more common in the hand, but the left incidence rate is slightly higher than the right, with no significant difference; In addition, a small number of L-GCTS were accompanied by damage to surrounding tissues, and 41 cases of FTS did not cause damage to surrounding tissues; L-GCTS and FTS are mostly single lesions, with a few being multiple lesions; Among 241 cases of L-GCTS, 235 were primary cases, 6 were recurrent cases, and 41 cases of FTS were all primary cases; The coincidence rate between preoperative imaging diagnosis and postoperative pathological diagnosis of L-GCTS was 89%, and the coincidence rate between preoperative imaging diagnosis and postoperative pathological diagnosis of FTS was 55.3%. The main reason was that it is easier to misdiagnose FTS as L-GCTS before surgery; There were certain differences in pathological and immunohistochemical manifestations between the two. Conclusion: L-GCTS and FTS are very similar in clinical features, disease course, predilection site, predilection age, tumor size, and tumor appearance. Imaging examination methods are difficult to distinguish between the two before surgery. The differentiation between the two mainly relies on histopathology and immunohistochemistry, and the two also exhibit different molecular genetics. Although both L-GCTS and FTS are benign tumors, their recurrence rates and other prognostic factors are different. Therefore, it is necessary to clearly distinguish between the two.