Recurrent giant cell tumour of distal Tibia: Case report and review of the literature (original) (raw)
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International Journal of Orthopaedics Sciences, 2017
Introduction: Giant cell tumour of bones is an unusual neoplasm that accounts for 4% of all primary tumours of bone, and it represents about 10% of malignant primary bone tumours with its different grades from borderline to high grade malignancy (1). GCT generally occurs in skeletally mature individuals with its peak incidence in in the third decade of life. Distal femur and proximal tibia are the commonest sites followed by distal radius (2), less than 4% of these tumours are known to affect the ankle joint, but the tumour's biological behavior at this site is quite unpredictable. Moreover, restoring the ankle joint functionality following tumour resection is a challenging task. Case Summary: 27 year old female presented with pain over right ankle since last two years. Biopsy was suggestive of Giant Cell Tumor of lower third tibia. We managed this case with intralesional curettage using phenol and bone cement as an adjuvant and reconstruction of defect by cementation along with locking plate. Conclusion: In cases of GCT, the management depends upon the various factors such as site, age, involvement of the bone, extent of bone involvement and whether there is articular involvement or not. Extra-articular GCT can be managed with extended intralesional curettage. Bone cement plays a dual role as an adjuvant as well as an agent for reconstruction of the defect.
2016
Giant cell tumor of bone is the commonest benign bone tumor encountered by an orthopedic surgeon. It is characterized radiographically as a lytic lesion occurring in the ends of bones and has a well-known propensity for local recurrence after surgical treatment (Campanacci et al., 1987). GCT generally occurs in skeletally mature individuals with its peak incidence in third decade of life. Distal femur and proximal tibia are the commonest sites followed by distal radius. Current treatment modalities include a meticulous curettage using high speed burrs and adjuvant therapy along with addition of bone graft or cement to pack the defect has significantly lowered the recurrence rates to less than 10% from 60% reported in the past with curettage alone (Canale et al., 2007). 21 year male presented with pain over right knee since last two years which was insidious in onset and gradually progressive. Biopsy was suggestive of Giant Cell Tumor of Proximal Tibia. We decided to manage the case ...
2017
Giant cell tumor of bone is the commonest benign bone tumor encountered by an orthopedic surgeon. It is characterized radiographically as a lytic lesion occurring in the ends of bones and has a well-known propensity for local recurrence after surgical treatment (Campanacci et al., 1987). GCT generally occurs in skeletally mature individuals with its peak incidence in third decade of life. Distal femur and proximal tibia are the commonest sites followed by distal radius. Current treatment modalities include a meticulous curettage using high speed burrs and adjuvant therapy along with addition of bone graft or cement to pack the defect has significantly lowered the recurrence rates to less than 10% from 60% reported in the past with curettage alone (Canale et al., 2007). 21 year male presented with pain over right knee since last two years which was insidious in onset and gradually progressive. Biopsy was suggestive of Giant Cell Tumor of Proximal Tibia. We decided to manage the case ...
Giant cell tumor of the distal tibia: report of a rare case
Giant cell tumour of bone is aggressive lesion, although benign. Foot and ankle bone involvement is rare. Herein, we present a case of a 26-year-old woman complaining of increasing pain and swelling along the antero-lateral aspect of the left ankle. Limitation of motion in the joint also occurred. Imaging and biopsy confirmed the diagnosis of giant cell tumour of bone. The lesion was treated with segmental en-bloc resection and ankle arthrodesis with good functional outcome. We also discuss clinical, radiological, and therapeutical characteristics of this pathology.
European Journal of Medical and Health Sciences
Introduction: Giant cell tumor (GCT) is a distinctive lesion characterized by the proliferation of multinucleate giant cells in a stroma of mononuclear cells; it is generally seen in skeletally mature individuals. GCT is usually found in the long bones around the knee or in the distal radius but distal end of tibia, proximal humerus, vertebrae of young adults are unusual location. We report a case of GCT of the distal end of tibia, with a secondary aneurysmal bone cyst, in a 26-year-old female. Based on our review of the medical literature, it appears that the occurrence of a GCT along with a secondary aneurysmal bone cyst (ABC) in distal end of tibia is less typical with challenging task for full tumor resection and restoration of ankle function to normal. Case Summary: 26 year old female presented with pain&swelling over left ankle since last six month. Biopsy was suggestive of GCT with ABC of lower third tibia. We managed this case with intralesional curettage using phenol and...
An Unusual Case of Giant Cell Tumor of the Distal Tibia
Journal of Orthopaedic Case Reports, 2018
Introduction: Giant cell tumors are common in proximal tibia and distal end radius and have a low tendency to recur. They have been treated successfully with excision and cementing or sandwich bone grafting without recurrence. Here, we present a rare case of giant cell tumor (GCT) of the distal tibia treated successfully with no recurrence at the end of 2 years. Case Report: A 28-year-old female presented with complaints of pain and restricted movement of the right ankle joint since 1 month. There was no history of trauma. On examination, tenderness on the anterior aspect of the right ankle joint with restricted range of motion was found. X-rays revealed a well-defined expansile predominantly lytic lesion in the distal epi-metaphyseal region of the right tibia with minimal periosteal reaction seen along the medial margin. Magnetic resonance imaging revealed an ill-defined expansile lesion involving the epi-metaphyseal end of the lower end of tibia causing cortical breach and having ...
Giant Cell Tumor of Lower End of Tibia
Case Reports in Orthopedics, 2013
Introduction. Giant cell tumor of bones is an unusual neoplasm that accounts for 4% of all primary tumors of bone, and it represents about 10% of malignant primary bone tumors with its different grades from borderline to high grade malignancy.Case Report. A 35-year-old patient presented with complains of pain and swelling in left ankle since 1 year following a twisting injury to his left ankle. On examination, swelling was present over the distal and anterior part of leg and movements of ankle joint were normal. All routine blood investigations were normal. X-ray and CT ankle showed morphology of subarticular well-defined expansile lytic lesion in lower end of left tibia suggestive of giant cell tumor. Histopathology of the tissue shows multinucleated giant cells with uniform vesicular nucleus and mononuclear cells which are spindle shaped with uniform vesicular nucleus suggestive of GCT. The patient was treated by excision, curettage, and bone cement to fill the defect.Conclusion. ...
Giant Cell Tumor of Bone: Six Years Institutional Retrospective Review, 2020
Introduction Surgery is the cornerstone for the management of giant cell tumors (GCTs). There are no definite guidelines for the management. The purpose of this series was to study the patient demography and results of the surgical intervention for skeletal GCTs in our population. Methods All the histologically diagnosed cases of GCT of bone from year 2012 to 2018 were retrospectively analyzed for patient demographics, site, and grade of the lesion, type of biopsy taken (if any), nature of surgical intervention, and final outcome with respect to complications. Results Seventeen cases of skeletal GCT were diagnosed on histopathology. The mean age at presentation was 31.5 ± 10.9 years with females affected 1.4 times more. Proximal tibia was the most common site (29.4%) followed by distal radius and dis-tal femur in that order. About 58.8% of the lesions were of Campanacci grade 2 and remaining were grade 3 lesions. Ten patients had extended curettage, five had en bloc resection, and one had amputation as the primary treatment. Twenty percent patients (n = 3) had local recurrence of the pathology and one patient developed distant recurrence (lung metastasis). Conclusion Proximal tibia followed by distal radius was the most common site of GCT in our population. The tumor behavior and recurrence cannot be predicted with any grading system. The goal should be salvage of the joint by intralesional curettage, with resection reserved for distal radius GCTs, cases with extensive soft tissue extension or those with destruction of the articular cartilage and joint involvement.