[Recurrence of finger tendon giant cell tumors after excision through a "shark teeth" approach. Report of 25 cases].

Local recurrences after excision of a giant cell tumor of the tendon sheath are classically related to incomplete excision. We have review a special group of circumferential tumors excised through a huge approach. Twenty-six circumferential tumors were excised between 1985 and 1998, through a special incision described by the senior author. It is composed of four triangular flaps drawn around the finger, one dorsal, one palmar (both proximally based) and two lateral (distally based). Six presented already with a recurrence of previous operations (mean 2.5 interventions). Some anatomical neighboring structure was "invaded" in all except one case. However the approach allows for a macroscopically satisfactory excision. Twenty-five patients were reviewed by an independent observator after a mean follow-up of six years. Six patients (24%) presented a recurrence after a mean postoperative delay of 17 months. Among them five have been already operated (83%) and five had multiple tumors. Satisfactory excision does not prevent recurrence and two types of distinct tumors exist. Recent immunohistological studies give support to this view and such examination is recommended.