TGCT is a tumor that surgeons or orthopedics rarely diagnose. The international literature cites less than 10 cases of TGCT in the ankle. An important characteristic of the tumor is its slow growth, which leads to its usual diagnosis only by coincidence. Differential diagnosis has to take a number of other tumors into account, including lipoma, ganglia or fibromas. Prior to an operation, it is usually very difficult to distinguish whether the tumor is benign or malignant.
In the first case discussed in this report, the patient was suffering from pain caused by an impingement syndrome at the ventral part of his ankle. The resection of the TGCT left the patient with no discomfort or pain.
In the second case, recurrent distortions led to an advanced arthrosis in the patient's upper ankle. The patient continued to feel discomfort even after the tumor had been removed; hence, the tumor was unlikely to have caused the symptoms she experienced. Clearly, the tumor in this patient was found only by coincidence. Ligament augmentation was not performed because of advanced arthrosis in the patient's upper ankle.
The therapy of choice consists of a resection of the tumor that follows the basic principles of oncology since the tumor has to be regarded as malignant until proven otherwise [6
]. A neoadjuvant or adjuvant therapy is not usually necessary [6
The etiology of TGCT has been discussed rather controversially in the literature. Our patients presented with persisting pain in the joint after they experienced certain traumas. The tumors were only detected accidentally. In both cases, however, it remains unclear whether distortion or chronic irritation of the upper ankle may have caused or influenced the development of TGCT.