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\begin{document}

\title{Unusual tumor of the toe}



\author[1]{Ines Lahouel}%
\author[1]{Nesrine Ben Salah}%
\author[1]{Manel Njima}%
\author[1]{Monia Youssef}%
\author[1]{Hichem Belhadjali}%
\author[1]{Jameleddine Zili}%
\affil[1]{Fattouma Bourguiba University Hospital of Monastir}%


\vspace{-1em}



  
  \date{April 17, 2024}


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\textbf{Unusual tumor of the toe}

\textbf{Key clinical message:} Giant Cell Tumor is a soft-tissue tumor
that has a very low potential for malignant change. Involvement of the
phalanges of foot is very rare and only a few cases have been reported.

\textbf{Key words:} Dermatology, oncology, Giant cell tumor, bone
tumors.

A 39-year-old woman presented with complaints of pain and swelling of
the left second toe for four months. The mass had been slowly increasing
in size over the previous 3 years. On examination, there was diffuse
swelling of the left second toe with erythematous and shiny overlying
skin (Figure 1). The X-ray showed an osteolytic expansive lesion with
cortical destruction in the region of the distal phalanx of the second
toe. No calcification or periosteal reaction was observed. Magnetic
resonance (MR) images showed a mass measuring 1\selectlanguage{ngerman}×1.5 cm that was
heterogeneously hypo intense on both T1- and T2-weighted MR images. This
mass showed a marked, diffuse and heterogeneous enhancement on the
contrast T1- weighted image. Surgical excision of the tumor was
performed. Histopathological examination confirmed the diagnosis of
Giant Cell Tumor (GCT) (Figure 2). The patient's postoperative course
was uneventful, and no recurrence or metastasis was observed. GCTs are
soft-tissue tumors that have a very low potential for malignant change.
It account for approximately 6\% of all bone
tumors.\textsuperscript{1,2} It typically involves the long bones in
young adults. \textsuperscript{1,2} Involvement of the phalanges of foot
is very rare and only a few cases have been
reported.\textsuperscript{1,2}

\textbf{Authors' contributions:}

\textbf{Ines Lahouel:} Conceptualization; data curation; formal
analysis; investigation; methodology; resources; validation;
visualization; writingoriginal draft; writing-review and editing.

\textbf{Nesrine Ben Salah:} Conceptualization; data curation; formal
analysis; investigation; methodology; resources; validation;
visualization; writingoriginal draft; writing-review and editing.

\textbf{Manel Njima:} Investigation; methodology.

\textbf{Monia Youssef:} Investigation; methodology.

\textbf{Hichem Belhadjali:} Investigation; methodology.

\textbf{Jameleddine Zili:} Investigation; methodology; project
administration; resources; supervision; validation; visualization;
writing-original draft.

\textbf{References:}

Fujisawa Y, Takahashi T, Kawachi Y, Otsuka F. Giant cell tumor of the
distal phalanx of the foot. \emph{Eur J Dermatol} . 2006
Mar-Apr;16(2):204-5.

Kiatisevi P, Thanakit V, Boonthathip M, et al. Giant cell tumor of the
distal phalanx of the biphalangeal fifth toe: a case report and review
of the literature. \emph{J Foot Ankle Surg} . 2011
Sep-Oct;50(5):598-602.

\textbf{Figure legends:}

\textbf{Figure 1:} A diffuse swelling of the left second toe with
erythematous and shiny overlying skin.

\textbf{Figure 2:} Proliferation of polymorphous cell population:
mononucleus~histiocytoid cells and

numerous osteoclast-like giant cells (HEx200).

Data sharing not applicable-no new data generated\selectlanguage{english}
\begin{figure}[H]
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\includegraphics[width=0.70\columnwidth]{figures/TCG-2-mod/TCG-2-mod}

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\includegraphics[width=0.70\columnwidth]{figures/Figure-2-TCG/Figure-2-TCG}

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