ANALYSIS OF GIANT CELL TUMOUR OF BONES: ITS PATTERN, VARIOUS TREATMENT MODALITIES AND THEIR RESULTS

Background: Giant cell tumour is a benign aggressive tumour of bone accounting for 5% of all primary bone tumours with feature of local recurrence, potential for metastasis and malignant transformation and usually seen at the end of long bones after skeletal maturity. The incidence of lung metastases from a histologically-proven GCT ranges from 1% to 9%. The recurrence rate after intralesional curettage without adjuvant therapy is reported to be up to 50%. Extended curettage with use of adjuvents is the treatment of choice for treating the most GCT of bones. Material and method: 25 patients presented with GCTBs included.In all patients standard plain anteroposterior and lateral radiographs of the involved extremity were done.MRI of involved extremity was done in 19 cases. Diagnosis confirmed by biopsy and histopathological examination. The treatment of GCT is directed towards local control without scarifying joint function. This has been traditionally achieved by intralesional curettage with autograft reconstruction by packing the cavity of excised tumour with iliac cortico-cancellous bone. Results: We have treated 25 patients of GCTBs. Females (15) were more commonly affected than male (10). Most common site for GCT was around the knee joint mostly in proximal tibia (6 out of 25). Average range of motion of knee joint was 60 to 112 degree and in wrist joint it was 0 to 45 degree of palmar flexion and 0 to 30 degree of dorsi flexion. Conclusion: We believe that removal of most of tumour mass by extended curettage is very essential step in preventing recurrence and achieving good functional outcome in future. Key words: giant cell tumour of bones, autograft, extended curettage

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The role of Denosumab in joint preservation for patients with giant cell tumour of bone

The Bone & Joint Journal ◽

10.1302/0301-620x.103b1.bjj-2020-0274.r1 ◽

2021 ◽

Vol 103-B (1) ◽

pp. 184-191

Author(s):

David Louis Perrin ◽

Julia D. Visgauss ◽

David A. Wilson ◽

Anthony M. Griffin ◽

Albiruni R. Abdul Razak ◽

...

Keyword(s):

High Risk ◽

Local Recurrence ◽

Giant Cell ◽

Giant Cell Tumour ◽

Lung Metastases ◽

Cell Tumour ◽

Joint Surface ◽

Intralesional Curettage ◽

Tissue Mass

Aims Local recurrence remains a challenging and common problem following curettage and joint-sparing surgery for giant cell tumour of bone (GCTB). We previously reported a 15% local recurrence rate at a median follow-up of 30 months in 20 patients with high-risk GCTB treated with neoadjuvant Denosumab. The aim of this study was to determine if this initial favourable outcome following the use of Denosumab was maintained with longer follow-up. Methods Patients with GCTB of the limb considered high-risk for unsuccessful joint salvage, due to minimal periarticular and subchondral bone, large soft tissue mass, or pathological fracture, were treated with Denosumab followed by extended intralesional curettage with the goal of preserving the joint surface. Patients were followed for local recurrence, metastasis, and secondary sarcoma. Results A total of 25 patients with a mean age of 33.8 years (18 to 67) with high-risk GCTB received median six cycles of Denosumab before surgery. Tumours occurred most commonly around the knee (17/25, 68%). The median follow-up was 57 months (interquartile range (IQR) 13 to 88). The joint was salvaged in 23 patients (92%). Two required knee arthroplasty due to intra-articular fracture and arthritis. Local recurrence developed in 11 patients (44%) at a mean of 32.5 months (3 to 75) following surgery, of whom four underwent repeat curettage and joint salvage. One patient developed secondary osteosarcoma and another benign GCT lung metastases. Conclusion The use of Denosumab for joint salvage was associated with a higher than expected rate of local recurrence at 44%. Neoadjuvant Denosumab for joint-sparing procedures should be considered with caution in light of these results. Cite this article: Bone Joint J 2021;103-B(1):184–191.

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Extended intralesional curettage preferred over resection–arthrodesis for giant cell tumour of the distal radius

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-019-02496-2 ◽

2019 ◽

Vol 30 (1) ◽

pp. 11-17 ◽

Cited By ~ 3

Author(s):

Hasan Abuhejleh ◽

Jay S. Wunder ◽

Peter C. Ferguson ◽

Marc H. Isler ◽

Sophie Mottard ◽

...

Keyword(s):

Giant Cell ◽

Distal Radius ◽

Giant Cell Tumour ◽

Cell Tumour ◽

Intralesional Curettage

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Computerised tomography features of giant cell tumour of the knee are associated with local recurrence after extended curettage

International Orthopaedics ◽

10.1007/s00264-021-05260-6 ◽

2021 ◽

Author(s):

Lenian Zhou ◽

Hongyi Zhu ◽

Shanyi Lin ◽

Hanqiang Jin ◽

Zhaoyuan Zhang ◽

...

Keyword(s):

Logistic Regression ◽

Local Recurrence ◽

Giant Cell ◽

Recurrence Rate ◽

Prognostic Value ◽

Giant Cell Tumour ◽

Cell Tumour ◽

High Recurrence Rate ◽

Multivariate Logistic Regression ◽

Extended Curettage

Abstract Background Extended curettage has increasingly become the preferred treatment for giant cell tumour of bone (GCTB), but the high recurrence rate after curettage poses a major challenge for orthopaedic surgeons. Computed tomography (CT) is valuable in the evaluation of GCTB. Our aim was to identify specific features of GCTB around the knee in pre-operative CT images that might have prognostic value for local recurrence. Methods We retrospectively analyzed data from 124 patients with primary GCTB around the knee who underwent extended curettage from 2010 through 2019. We collected demographic, clinical, and therapeutic data along with several CT-derived tumour characteristics. CT-derived tumor characteristics included tumour size, the distance between the tumour edge and articular surface (DTA), and destruction of posterior cortical bone (DPC). Akaike information criterion (AIC) was used to select which variables to enter into multivariate logistic regression models and to determine significant factors affecting recurrence. Results The total recurrence rate was 21.0% (26/124), and the average follow-up time was 69.5 ± 31.2 months (24–127 months). Age, DTA (< 2 mm), and DPC were significantly related to recurrence, as determined by multivariate logistic regression. The C-index of the final model was 0.79 (95% CI: 0.71 to 0.88), representing a good model for predicting recurrence. Conclusion Identifying certain features of GCTB around the knee on CT has prognostic value for patients treated with extended curettage. A three-factor model predicts tumour recurrence well after extended curettage.

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Lung metastases of diffuse giant cell tumour of the fibular tendon sheath at the ankle: A case report

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2016.10.018 ◽

2017 ◽

Vol 103 (3) ◽

pp. 399-402 ◽

Cited By ~ 1

Author(s):

P.-S. Marcheix ◽

T. Roger ◽

J.-M. Coindre ◽

I. Pommepuy ◽

J.-L. Charissoux ◽

...

Keyword(s):

Case Report ◽

Giant Cell ◽

Giant Cell Tumour ◽

Lung Metastases ◽

Tendon Sheath ◽

Cell Tumour

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Giant cell tumour of EHL tendon sheath in young: a rare case report and review of the literature

BMJ Case Reports ◽

10.1136/bcr-2021-242980 ◽

2021 ◽

Vol 14 (9) ◽

pp. e242980

Author(s):

Subodh Kumar Pathak ◽

Abhijeet Ashok Salunke ◽

Jagandeep Singh Virk ◽

Naveen Kumar

Keyword(s):

Giant Cell ◽

Giant Cell Tumour ◽

Tendon Sheath ◽

En Bloc Resection ◽

Bloc Resection ◽

Cell Tumour ◽

Tumour Mass ◽

En Bloc ◽

Second Metatarsal ◽

Rare Case Report

Giant cell tumour of tendon sheath also known as benign synovioma is a slow-growing benign tumour originating from tendon sheath, ligaments or bursa. We present a case of swelling over the left foot of 7-month duration in 11-year-old boy diagnosed as giant cell tumour of tendon sheath. There was an extensive pressure effect of tumour mass on the second metatarsal evident by scalloping. Local excision was planned and executed, and reduction in scalloping was evident at 26-month follow-up with no recurrence. We conclude that en bloc resection of tumour with a hydrogen peroxide lavage may result in a favourable prognosis without recurrence.

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