The patient refused treatment or was lost to follow up in 2019 and re-presented 12 and 24 months later.

Finally, amputation was performed and the pathology report was:

This is an ulcerated tumor composed of abundant multinucleated osteoclast-like giant cells and mononuclear cells, with scattered mitotic figures. There is extensive hemorrhage, and a focal sclerotic stroma, but no definite osteoid matrix is identified. There are scattered small foci of extramedullary hematopoiesis within the tumor. No cytologically malignant features are present.
DIAGNOSIS:  Tumor of third finger: Giant cell-rich neoplasm.

 Giant cell tumor of bone is rare in the hand. The differential for the appearance on the presenting images would include Enchondroma. This tumor was slow growing and had affected the growth of the proximal metacarpal. Subsequent images could suggest chondrosarcoma. A chest x-ray was performed and no pulmonary nodules were identified.