Recognizing TGCT and Shifting Referral Patterns

R. Lor Randall, MD, FACS, of UC Davis Health, opens this OncLive Insights discussion on tenosynovial giant cell tumor (TGCT) with Dale R. Shepard, MD, PhD, of Cleveland Clinic, and Alexander B. Christ, MD, of UCLA Health. Dr Christ describes TGCT as a benign but potentially destructive tumor of the joints and tendon sheaths that was once considered 2 separate conditions. Localized disease is usually a solitary nodule managed well with surgery, while diffuse disease infiltrates the joint and is far harder to remove. He explains that diagnosis is often delayed because young, active patients blame knee pain on sports and live with intermittent swelling for years. Dr Shepard says that since the first systemic therapies were approved about 7 years ago, he sees patients with diffuse disease earlier, sometimes before any surgery. Dr Christ adds that radiologists now flag possible TGCT on magnetic resonance imaging, fast-tracking patients to tertiary referral centers.