Giant Cell Tumor of bundle sheath.


Giant cell tumor of bundle sheath is a type of nodular tumor that develops in the hands and feet. It affects the tendon sheath present in these parts. This tumor is also known as a pigmented villonodular tumor of the tendon sheath (PVNTS).


Furthermore, cancer typically affects individuals who lie within the age group of 30 to 50. The tumor grows slowly and leads to the development of painless lesions in the body.


Moreover, cancer is 2nd most develops in the hands. Besides, the tumor is benign. It means that it doesn’t spread from one part to another.



The exact cause for what causes giant cell tumor of the bundle sheath is not clear. However, researchers are studying various factors that could increase the chance of developing this cancer.


Furthermore, various researchers credit several factors for this cancer. The main ones include trauma, osteoclastic proliferation, inflammation, several metabolic disturbances, and more.

Also, disturbances in lipid metabolism, immune mechanism, and neoplasia might have some connections with the development of cancer. However, the clear reason for what causes this cancer is still doubtful.




There are several symptoms that you can develop in Giant Cell Tumor of bundle sheath. However, in many patients, cancer shows no symptoms at all.


Moreover, one of the most common symptoms includes the presence of a slowly growing mass in the hands. This mass is present in the soft tissues present near the tendon. In certain patients, the mass keeps enlarging in size.


Other symptoms include the development of pain. Furthermore, this pain may become worse with certain activities. For instance, wearing shoes if you have a tumor in your feet may become painful.





Physical examination and differential diagnosis. 

Your doctor will use different methods and tests to detect your giant cell tumor of bundle sheath. He/she is going to do a thorough physical check-up before ordering you for tests.

When it comes to a physical exam, he/she will look for nodular and firm masses in the skin. Furthermore, unlike other masses, these masses do not transilluminate. In case your doctor suspects the tumor masses, he/she may try other differential tests.


In differential diagnosis, your doctor will try to differentiate between the different tumor masses. Giant cell tumor of bundle sheath also shows some peculiar characteristics, not present in others.


Imaging tests. 


Your doctor may also use several imaging tests to further evaluate the giant cell tumor of the bundle sheath. For instance, your doctor may use radiography.

Radiography. In radiography, your doctor will be able to see the erosion on your bones. In this method, X-rays, gamma rays of other ionizing and non-ionizing radiations help create internal images of your tissues.


Ultrasound. Ultrasound is another test that helps to find out the relationship of a lesion with another adjacent lesion. In an ultrasound, the giant cell tumor of the bundle sheath may show some internal vascularity. Furthermore, the tumors show a clear texture that is present in these tumors.


MRI. Your doctor may use this method to find out a giant cell tumor of bundle sheath. . This scan produces radio waves and X-rays to produce a 3D image of your nerves and soft tissues.

Therefore, your doctor can find out if you have a tumor or not and the location of the tumor. The focal form appears with lower signal intensity on an MRI.

Furthermore, the tumor cells show a brown color under a microscope. The giant cells that appear under a microscope are usually multinucleated. Biopsy. To confirm a giant cell tumor of bundle sheath, your doctor may use biopsy. He/she will take a sample of tissue and examine it under a microscope. Moreover, the tumor cells show a definite proliferation which is not present in normal cells.




There is no specific treatment for giant cell tumor of bundle sheath. Therefore, the most common treatment option involves complete local excision of the tumor.


However, the major problem for the treatment is the recurrence of the tumor. Usually, 44 percent of total tumors show recurrence. Therefore, in case of recurrence of the tumor, marginal excision is a better option.

Thus, it is clear that treatment involves either limiting the growth of treatment or complete removal. Furthermore, the tumor shows more recurrence if it extends to joints and deeper to the volar tumors


Thus, the involvement of the tendon has a greater connection with recurrence. Furthermore, the location and size of the tumor determine the type of operative approach.


Coping and support 


When you get diagnosed with giant cell tumor of bundle sheath, it could be frightening for you. The condition will be no different for your family.


However, you may learn to cope with the uncertainty and distress related to cancer with time.  Thus, you need to follow these instructions until then;


Call on for medical support:


Various things are going to help you. For instance, the knowledge and understanding of a medical social worker, or any other mental health professional is necessary. They will help you in understanding your cancer.


Furthermore, if your child or other family member suffers from cancer, you need to ask health care professionals for advice. They will provide you with options for medical health support. This will also provide you with emotional and social support.


In addition to this, you can check various online services that will provide you support to combat cancer.


  • Gain more knowledge about giant cell tumor of bundle sheath to make decisionsabout control and care: 


Ask your doctor about various treatment options related to giant cell tumor of bundle sheath. Little knowledge is dangerous. Therefore, more confidence in understanding and making decisions about treatment options will be there with you. So you should always learn more about the disease.


Ask the health care team for guidance if your child has cancer. Therefore, get more and more information for appropriately caring for the patient.


Be close to your friends and family:

A close and strong relationship with your family and friends is necessary. It will help you deal with giant cell tumor of bundle sheath.


You need practical support, moral support from your friends and relatives. Thus, someone should be there for you to look after the family. Emotional support from them is going to matter most. Thus, a healthy and happy person will ultimately efficiently fight the disease.


Prepare for your appointment


You are likely to start making an appointment with your primary care doctor if some signs and symptoms worry you. Ask for a referral to an experienced specialist if your doctor suspects giant cell tumor of bundle sheath.


A team of specialists typically can treat. For instance;

Tumor surgeons who have specialization in operating soft tissue cancers.

Doctors who have a specialization in treating cancers with systemic medications or chemotherapy.

Pathologists diagnose the specific type of cancer by analyzing a tissue.

Rehabilitation specialists who after surgery help in the recovery of a tumor.


What you should expect from your doctor:


You will face several questions from your doctor. Thus, you should be ready to answer these. So, give more time to your doctor to address them. Your doctor may ask;


What signs and symptoms concern you more?


Have your symptoms been occasional or continuous?


When did you start to notice the symptoms?

The severity of your symptoms?


Is there anything that improves your symptoms?


Is there anything that worsens your symptoms?


Do you have any family or personal history of cancer?