Clinical Experience With Pediatric Tenosynovial Giant Cell Tumor: A Single-Center Observational Study

Key Clinical Summary:

• Design/Population: A single-center observational study evaluated 24 pediatric patients with histologically confirmed tenosynovial giant cell tumor diagnosed between 1998 and 2023 (median age 12.25 years; equal sex distribution).
• Key Outcomes: The knee was the most commonly involved joint (75%), with localized nodular disease in 66.7%. Universal presenting symptoms included mechanical pain (100%), with frequent joint effusion (79.1%). MRI identified TGCT in all cases, with confirmation by arthroscopic biopsy. Most patients underwent arthroscopic synovectomy (70.8%). Over a median follow-up of 98 months, 6 recurrences occurred, all in diffuse-type TGCT of the knee.
• Clinical Relevance: MRI is the preferred diagnostic and surveillance modality for pediatric TGCT. Surgical resection provides durable control for localized disease, while diffuse TGCT carries a higher recurrence risk, supporting consideration of open surgery and local adjuvant strategies in recurrent cases.

A single-center observational study of pediatric patients with tenosynovial giant cell tumor (TGCT) explored real-world clinical presentation, imaging findings, treatment strategies, and long-term outcomes.

There were a total of 24 pediatric patients included in the study. Patients were diagnosed between 1998 and 2023 with histologically confirmed TGCT. The median age at diagnosis was 12.25 years (standard deviation [SD], 3.78), with an equal gender distribution. 

The most frequently involved joint was the knee (75%), and most cases presented with localized nodular disease (66.7%). Among patients, initial symptoms included mechanical pain (100%), joint effusion (79.1%), and limping (25%), with an average symptom duration of 9 (range, 4 to 15) months prior to diagnosis.

In all cases, MRI was effective in identifying TGCT and histologically confirmed via arthroscopic biopsy. Among 5 patients, radiographs showed soft tissue changes. 

In terms of treatment, most patients underwent arthroscopic synovectomy (70.8%), while 29.2% were treated with open surgery. The median follow up was 98 months (range, 6 to 288 months, during which 6 recurrences were reported, all involving diffuse-type TGCT localized to the knee.

The researchers concluded, “MRI is the preferred method for diagnosis and follow-up. Surgery is the main treatment, with low recurrence if nodular lesions are accurately removed.”

They added, “Outcomes and recurrence depend on diffuse presentation. We recommend open surgery for recurrences and local adjuvant treatment.”

Source:

Moreno-Romo D, Inarejos-Clemente EJ, Ferran Torner-Rubies, Perez-Lopez LM, Guerris-Fernandez A, Garcia RG. Tenosynovial giant cell tumour in children. Our experience with 24 patients in a third level Children’s Hospital, an observational study. European Journal of Pediatrics. 2025;184(10):627-627. doi:10.1007/s00431-025-06416-x