Giant Cell Tumour of Proximal Phalanx of Thumb; an Extremely Rare Case Presentation

IntroductionGCT is a bone tumor involving epiphyseal area of bone abutting the subchondral bone. Commonly found in long bones like proximal tibia and distal femur. We report a case of GCT of proximal phalanx of thumb in a 42 year old male patient. Case reportA 42 years old male presented to us with a swelling in lt thumb region which was gradually progressive for last 6 months. There was no associated trauma. On examination, it was fusiform in appearance and was located over proximal phalanx. X rays showed an expansile lytic lesion involving whole of proximal phalanx with an articular breakage. We went for a surgical procedure and proximal phalanx along with whole mass was disarticulated and double arthrodesis of distal interphalangeal joints and metacarpophalangeal joints with iliac crest tricortical graft was done. Conclusion GCT is an aggressive tumour and potentially malignant lesion. Usually it presents as a solitary lesion but when GCT occur in hand it frequently cause severe bony destruction and extend into surrounding soft tissue. When compared with GCT arising at more proximal location tumour of the hand more commonly present at advanced stage with major bony destruction and diaphyseal extension which complicates treatment. Proper investigations and histopathological examination is necessary for accurate diagnosis and further treatment planning. Early treatment helps in complete excision of tumor along with return of adequate function of the patient