Dr. Abraham on the Surgical Management of TGCT

John A. Abraham, MD, FACS, founder, Orthopaedic Oncology Service, Rothman Orthopaedic Institute, and attending surgeon, Orthopaedic Surgery, Fox Chase Cancer Center, discusses the surgical management of patients with tenosynovial giant cell tumor (TGCT).

Surgical intervention is dependent on what joint the disease is located in, Abraham says. Ultimately, the goal of surgery is to rid the patient of the diseased synovium, while leaving an adequate amount healthy tissue.

Diseased synovium tissue has a purplish discoloration due to hemosiderin pigmentation that deposits from the significant amount of bleeding associated with TGCT, Abraham explains. As such, identifying what tissues needs to be removed during surgery is relatively straightforward.

The surgical techniques employed are dependent on the site of disease, but are always specialized and extensive, Abraham says. Some examples include anterior and posterior operations of the knee, surgical dislocation of the hip or shoulder, and opening an ankle joint to see the full extent of disease.

As these are specialized procedures, it is important that patients are operated on by orthopedic surgeons who are familiar with and comfortable performing these surgeries, concludes Abraham.