Giant cell tumors of the child's fibula: a case study (original) (raw)
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A Case Report of Giant Cell Tumor of Proximal Fibula in Children
2020
Giant cell tumour (GCT) is histopathologically benign tumor of long bone particularly in distal femur and the proximal tibia. It commonly occurs in adults of age 20-40 years but rare in children. GCT is considered to be locally aggressive tumor and tendency of recurrence is higher even after surgery. The clinical features are nonspecific, the principle symptoms are pain, swelling and limiting adjacent joint movements. Diagnosis is based on the radiographic appearance and histopathological findings .In our case X-ray showed ill defined lytic lesion on proximal fibula with cortical thinning and MRI finding revealed expansile lytic lesion in meta-epiphysis of right fibula 16×16×28mm adjacent to growth plate with fluid level. The sclerotic rim appears hypointense on T1 & hyperintense on T2. Core needle biopsy showed giant cell tumor on proximal fibula. Considering the risk of recurrence wide local excision was done. Management of GCT of proximal fibula in young patient is critical for p...
A Rare Giant Cell Tumour of the Distal Fibula and its Management
Cureus, 2016
Giant Cell Tumour (GCT) of the distal fibula is extremely rare and poses challenges in the surgical management. Wide excision or intralesional curettage, along with adjuvant chemical cauterisation can prevent the recurrence of GCT. The excised bone gap needs reconstruction using tricortical iliac autograft and supportive plate fixation. In addition to wide excision, preservation of ankle mortise is advisable in locally aggressive and large lesions of the distal fibula. We report a GCT of the distal fibula in a young female patient. As part of the treatment, en bloc resection, chemical cauterisation with phenol, and distal fibula reconstruction with a tricortical iliac crest bone graft was done. Eighteen months after the treatment, the patient has no recurrence and her ankle is stable with full range of movement. We suggest this method to be worthwhile for the treatment of this uncommon lesion in quantifying recurrence and functional outcome.
Giant Cell Tumor Arising from Fibular Head in Immature Skeleton Treated with Marginal Excision
Journal of College of Medical Sciences-Nepal, 2018
Giant Cell tumor (GCT) is the benign tumor commonly found in second to fourth decade of life. Proximal fibula is very rare site and its occurrence in immature skeleton is still rare with very limited case report. We present a case of painful bony lesion arising from proximal fibula diagnosed as GCT in 15 year boy which was managed successfully with marginal excision and lateral collateral ligament anchorage in proximal tibia. There is no evidence of local recurrence, lung metastasis, knee pain and instability till 24 months of follow up.
Giant cell tumour in the foot of a skeletally immature girl: a case report
Journal of orthopaedic surgery (Hong Kong), 2009
We present a case of delayed diagnosis of a benign giant cell tumour (GCT) of the third metatarsal in a skeletally immature girl. The patient underwent en bloc excision of the tumour. The tumour had replaced the third metatarsal and had infiltrated the surrounding soft tissue and the second and fourth metatarsal bases. Deep, lateral and medial margins were all involved. A high index of suspicion is needed when evaluating any tumours of the foot, because the compact structure of the foot may delay diagnosis. Early detection is important for avoiding amputation, as the hindfoot and midfoot are classified as one compartment and radical resection is impossible to achieve. Tumours grow faster in the foot than in other bones. GCT in this location and age-group are rare and should be considered in the differential diagnosis of a destructive bony lesion in skeletally immature patients.
Osteoscopic Surgery of Giant Cell Tumor of Bone for Preservation of Proximal Fibula
Anticancer Research, 2018
Background: Osteoscopy is a minimally-invasive endoscopic technique for inspecting lesions inside bone marrow cavities. We describe the feasibility of osteoscopic surgery of giant cell tumor of bone (GCTB) in order to preserve the proximal fibula, and thereby achieve immediate recovery and avoid complications. Patients and Methods: Five patients with GCTB in the proximal fibula were treated using osteoscopic curettage with adjuvants (argon plasma coagulation and cementation). Functional outcome was evaluated by knee stability, Musculoskeletal Tumor Society (MSTS) rating, and Tegner score. Oncological outcome was evaluated for local recurrence and pulmonary metastasis. Results: Regarding functional outcome, knee instability was negative in all cases. Mean MSTS rating was 100%. Tegner scores were the same as those prior to surgery. Neither local recurrence nor pulmonary metastasis were found. Conclusion: Osteoscopic surgery is feasible for immediate and complete recovery, and can improve quality of life for patients with GCTB of the proximal fibula with satisfactory oncological outcome.
Giant Cell Tumor of Bone in Skeletally Immature Patients - A Clinical Perspective
Journal of orthopaedic case reports
Giant cell tumors of skeleton are very rare in pediatric and adolescent population. Here we report two cases-one a fifteen year old child with swelling distal humerus and another a case of a thirteen year old child with pain and swelling proximal tibia. A fifteen year old child presented to department of orthopedics of our institute with complaint of difficulty in moving upper limb and swelling distal humerus. Another patient who was a 13 years old male had painful ambulation and swelling in upper tibia. MRI followed by core needle biopsy was done in both the patients confirming the mass to be giant cell tumor which is quite rare in this age group. First patient was managed by wide excision and total elbow replacement and second one by curettage, cementation and augmentation with plate-screw construct. Giant cell tumour of skeleton is highly uncommon in pediatric age group. It should be considered as one of the differential diagnosis of epiphyseo metaphyseal lesions in pediatric pop...
JOURNAL OF CLINICAL AND BIOMEDICAL SCIENCES
Giant cell tumor (GCT) account around 5% of bone tumors with a slight female preponderance. We are presenting a case 32yr old gentleman, who presented with c/o swelling present on lateral aspect of proximal third of left leg for past one year and pain over the swelling for past 3 months with no significant history of trauma. X ray revealed solitary lytic lesion with thin rim of cortex over proximal fibula. MRI showed a lytic le-sion over sub articular area with internal septation having a “bubbly” appearance involving left fibula with mass effect on lateral tibial plateau. Intraoperatively tibia appears to be normal. Histopathological examination of the excised mass revealed giant cell tumor of proximal fibula with secondary aneurysmal bone cystic (ABC) changes with the margins free of tumor. Postoperatively, patient is pain free with loss of dorsiflexion of foot with loss of sensation over dorsum and he is put on regular follow up. Key-words: Giant cell tumour, Proximal fibula, Ane...
Giant cell tumour of foot bones - 25 years experience in a tertiary care hospital
JPMA. The Journal of the Pakistan Medical Association, 2015
To determine the incidence of giant cell tumour in foot, its clinical features, stage of tumour, treatment and outcome of surgery. This retrospective case series study was conducted at Jinnah Postgraduate Medical Centre, Karachi, and comprised cases of giant cell tumour of foot bones diagnosed between January 1990 and March 2015. Tumour Incidence, type of procedure and results were recorded on a proforma and analysed for function outcome and recurrence. Clinical and radiological follow-up was done for a maximum 6 years. There were 240 cases of giant cell tumour but only 13(5.4%) related to foot bones. Of them, 8 (3.3%) were females and 5(2.0%) males. The mean age was 25 years (SD 10.59) (range: 17-38 years). In 7 (2.9%) cases lesion was in metatarsals, 2(0.8%) cases in phalanges, 3(1.2%) cases in calcaneus and 1(0.4%) case in talus. Duration of symptoms ranged from 4 to 12 months. All presented with radiologically stage 2 or 3 lesions. Resection of tumour and reconstruction with fib...
Case Report GIANT CELL TUMOR OF LOWER END OF FEMUR IN A SKELETALLY IMMATURE-A RARE CASE
2013
Giant cell tumor (GCT) is a benign locally aggressive tumor with a tendency for local recurrence. GCT of lower end of femur in a skeletally immature patient is of rare occurrence with very few cases reported so far. GCT in this location in skeletally immature patient is rare and should be considered in the differential diagnosis of a destructive bony lesion in both skeletally immature and mature patients. We report the rare case of GCT of lower end of right femur in a 10-year-old female and discuss the difficult aspects of diagnosis.
Frontiers in Pediatrics
The Giant Cell tumor (GCT) is a benign, locally aggressive lesion that cause bone destruction and shows a malignant potential. It is a relatively common skeletal tumor that is therefore typically seen in young adults. Few cases are described in literature of GCT in the immature skeleton, and the metatarsal is an unusual location for a primary bone GCT, especially in pediatric age. Therefore, there are very few data reported regarding the management protocol of GCT in metatarsal bones. We report a case about the use of no vascularized fibular graft for an original Y-shaped reconstruction of the metatarsal bone after Giant Cell Tumor resection in a 9 years-old patient, and performed a literature review about metatarsal bone reconstruction in skeletally immature patient.