Diagnostic Challenge of Localized Tenosynovial Giant Cell Tumor in Children

This report describes a rare case of a pediatric tenosynovial giant cell tumor (TSGCT) with a delayed diagnosis. A 9-year-old boy presented with a 3-month history of knee pain and swelling, initially attributed to a femoral non-ossifying fibroma and arthritis based on computed tomography findings an...

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Main Authors: Jiro Ichikawa, Satoshi Ochiai, Tomonori Kawasaki, Kojiro Onohara, Masanori Wako, Hirotaka Haro, Tetsuo Hagino
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/3/281
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author Jiro Ichikawa
Satoshi Ochiai
Tomonori Kawasaki
Kojiro Onohara
Masanori Wako
Hirotaka Haro
Tetsuo Hagino
author_facet Jiro Ichikawa
Satoshi Ochiai
Tomonori Kawasaki
Kojiro Onohara
Masanori Wako
Hirotaka Haro
Tetsuo Hagino
author_sort Jiro Ichikawa
collection DOAJ
description This report describes a rare case of a pediatric tenosynovial giant cell tumor (TSGCT) with a delayed diagnosis. A 9-year-old boy presented with a 3-month history of knee pain and swelling, initially attributed to a femoral non-ossifying fibroma and arthritis based on computed tomography findings and slightly elevated C-reactive protein levels. The symptoms persisted despite medical treatment. Magnetic resonance imaging (MRI) revealed a tumor in the posterior compartment. He underwent surgery, and the pathology confirmed the diagnosis of localized TSGCT. Six months postoperatively, the patient remained asymptomatic. Pediatric knee pain is a complex symptom associated with inflammatory conditions and benign and malignant tumors. Benign tumors, as in this case, can be misdiagnosed as arthritis, delaying diagnosis and treatment. MRI is recommended in cases involving symptom persistence. However, histopathological, immunohistochemical, and morphological examinations are crucial for definitive diagnosis, particularly when the imaging findings are inconclusive.
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spelling doaj-art-73bc7ddb441944038ed6746da24a43fe2025-08-20T02:12:25ZengMDPI AGDiagnostics2075-44182025-01-0115328110.3390/diagnostics15030281Diagnostic Challenge of Localized Tenosynovial Giant Cell Tumor in ChildrenJiro Ichikawa0Satoshi Ochiai1Tomonori Kawasaki2Kojiro Onohara3Masanori Wako4Hirotaka Haro5Tetsuo Hagino6Department of Orthopaedic Surgery, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo 409-3898, Yamanashi, JapanDepartment of Orthopaedic Surgery, National Hospital Organization (NHO), Kofu National Hospital, Kofu 400-8533, Yamanashi, JapanDepartment of Pathology, Saitama Medical University International Medical Center, Hidaka 350-1298, Saitama, JapanDepartment of Radiology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo 409-3898, Yamanashi, JapanDepartment of Orthopaedic Surgery, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo 409-3898, Yamanashi, JapanDepartment of Orthopaedic Surgery, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo 409-3898, Yamanashi, JapanDepartment of Orthopaedic Surgery, National Hospital Organization (NHO), Kofu National Hospital, Kofu 400-8533, Yamanashi, JapanThis report describes a rare case of a pediatric tenosynovial giant cell tumor (TSGCT) with a delayed diagnosis. A 9-year-old boy presented with a 3-month history of knee pain and swelling, initially attributed to a femoral non-ossifying fibroma and arthritis based on computed tomography findings and slightly elevated C-reactive protein levels. The symptoms persisted despite medical treatment. Magnetic resonance imaging (MRI) revealed a tumor in the posterior compartment. He underwent surgery, and the pathology confirmed the diagnosis of localized TSGCT. Six months postoperatively, the patient remained asymptomatic. Pediatric knee pain is a complex symptom associated with inflammatory conditions and benign and malignant tumors. Benign tumors, as in this case, can be misdiagnosed as arthritis, delaying diagnosis and treatment. MRI is recommended in cases involving symptom persistence. However, histopathological, immunohistochemical, and morphological examinations are crucial for definitive diagnosis, particularly when the imaging findings are inconclusive.https://www.mdpi.com/2075-4418/15/3/281tenosynovial giant cell tumorlocalizeddifferential diagnosisknee pain in childrenmagnetic resonance imaginghistopathology
spellingShingle Jiro Ichikawa
Satoshi Ochiai
Tomonori Kawasaki
Kojiro Onohara
Masanori Wako
Hirotaka Haro
Tetsuo Hagino
Diagnostic Challenge of Localized Tenosynovial Giant Cell Tumor in Children
Diagnostics
tenosynovial giant cell tumor
localized
differential diagnosis
knee pain in children
magnetic resonance imaging
histopathology
title Diagnostic Challenge of Localized Tenosynovial Giant Cell Tumor in Children
title_full Diagnostic Challenge of Localized Tenosynovial Giant Cell Tumor in Children
title_fullStr Diagnostic Challenge of Localized Tenosynovial Giant Cell Tumor in Children
title_full_unstemmed Diagnostic Challenge of Localized Tenosynovial Giant Cell Tumor in Children
title_short Diagnostic Challenge of Localized Tenosynovial Giant Cell Tumor in Children
title_sort diagnostic challenge of localized tenosynovial giant cell tumor in children
topic tenosynovial giant cell tumor
localized
differential diagnosis
knee pain in children
magnetic resonance imaging
histopathology
url https://www.mdpi.com/2075-4418/15/3/281
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