scholarly journals Liquid Nitrogen Efficiency in Treatment of Giant Cell Tumor of Bone and Prevention of Recurrence

2020 ◽  
Vol 10 (18) ◽  
pp. 6310
Author(s):  
Cosmin Ioan Faur ◽  
Ahmed Abu-Awwad ◽  
Daniel Laurențiu Pop ◽  
Carmen Lăcrămioara Zamfir ◽  
Daniela Gurgus ◽  
...  
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Liquid Nitrogen ◽  
Bone Lesion ◽  
Cell Tumor ◽  
Iliac Bone ◽  
Nitrogen Efficiency ◽  
Resection Margins ◽  
Recurrence Rates ◽  
Intralesional Curettage

Giant cell tumor (GCT) of bone is a benign aggressive bone lesion with significant recurrence rates following surgical curettage. Historically, these tumors were approached by performing an intralesional curettage of the tumoral tissue by filling the resulting cavity using morselized iliac bone autograft. The major problems of this therapy were the high recurrence rates of up to 40–50%. Several adjuvant treatments have been proposed in order to augment resection margins, including liquid nitrogen (LN), phenol, ethanol, hydrogen peroxide (H2O2) and bone cement (polymethyl methacrylate (PMMA)). LN can be used either to preserve tissues or for controlled necrosis depending on the cycles of freezing and thawing. Usually, a quick freeze followed by a slow thaw will lead to destruction of human cells. This article reviews the results of cryosurgery with LN associated with surgical resection and the additional use of PMMA in a small group of patients with a histopathological confirmation of bone GCT with different localizations (i.e., tibia, distal radius and iliac bone). Cryosurgery with LN of bone GCT proved to be an efficient tool to decrease the recurrence rate for this tumoral type. In our series of cases, there were no complications, oncological or otherwise, at the two-year minimum follow-up, with good and excellent functional results.

scholarly journals Giant Cell Tumor: A Rare Condition in the Immature Skeleton—A Retrospective Study of Symptoms, Treatment, and Outcome in 16 Children

Sarcoma ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Thale M. Asp Strøm ◽  
Anette Torød Skeie ◽  
Ingvild Koren Lobmaier ◽  
Olga Zaikova
Keyword(s):  
Retrospective Study ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Rare Condition ◽  
Functional Results ◽  
Cell Tumor ◽  
Initial Symptom ◽  
Recurrence Rates ◽  
Intralesional Curettage ◽  
Immature Skeleton

Background. Pediatric giant cell tumor (GCT) of bone is rare and the course of the disease in the immature skeleton is sparsely described. We performed a retrospective study addressing symptoms, treatment, and outcome in children with GCT.Methods. Review of medical records and images of patients with GCT. Patients were detected from our hospital prospective database and those with open epiphyseal cartilages were included.Results. 16 children (75% girls) from 6 to 15 years old were identified. Eight lesions (50%) were in long bones and 4 (25%) in flat bones. One lesion appeared to be purely epiphyseal. All patients had pain as the initial symptom. Local recurrence developed in 2 patients. 14 of 16 patients returned to normal activity with no sequelae. One patient developed anisomelia after surgery.Conclusions. The biological tumor behavior in children does not seem to differ from what is reported in adults. Lesions in flat bones are very unusual, but our data alone do not provide enough evidence to conclude that this is more common in the immature skeleton. Literature review showed only one previous case report describing a purely epiphyseal GCT. Intralesional curettage is appropriate treatment and gives good functional results with acceptable recurrence rates.

Vascularized Iliac Bone Lining in Downgraded Treatment of Campanacci Grade III Giant Cell Tumor of the Distal Radius

2018 ◽  
Vol 23 (02) ◽  
pp. 255-258
Author(s):  
Kazufumi Sano ◽  
Kazumasa Kimura ◽  
Satoru Ozeki
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Distal Radius ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Cell Tumor ◽  
Iliac Bone ◽  
En Bloc ◽  
Intralesional Curettage ◽  
Grade Iii

It is commonly accepted that wide en bloc resection followed by reconstruction is essential in progressive lesions (Campanacci grade III) for local control of possible recurrence. However, specific grade III can be downgraded and treated with intralesional curettage to preserve better wrist function, without increasing the recurrency rates. In this report, Grade III giant cell tumor of the distal radius was successfully treated using vascularized osseous graft from the inner lip of the iliac bone in addition to downgrading strategy.

scholarly journals A Systematic Review and Meta-Analysis of En-Bloc vs Intralesional Resection for Giant Cell Tumor of Bone of the Distal Radius

2013 ◽  
Vol 7 (1) ◽  
pp. 103-108 ◽  
Author(s):  
Theresa J.C Pazionis ◽  
Hussain Alradwan ◽  
Benjamin M Deheshi ◽  
Robert Turcotte ◽  
Forough Farrokhyar ◽  
...  
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Distal Radius ◽  
Wrist Joint ◽  
Meta Analysis ◽  
En Bloc Resection ◽  
Cell Tumor ◽  
En Bloc ◽  
Intralesional Curettage ◽  
Functional Benefit

Introduction: Surgical management of Giant Cell Tumor of Bone of the distal radius (GCTDR) remains controversial due to risk of local recurrence (LR) offset by functional limitations which result from en-bloc resection. This study aims to determine the oncologic and functional outcomes of wide excision (WE) vs intralesional curettage (IC) of GCTDR. Methods: A complete search of the applicable literature was done. Included studies reported on patients from the same cohort who were surgically treated for GCTDR with WE or IC. Two reviewers independently assessed all papers. The primary outcome measure was LR. Results: One-hundred-forty-one patients from six studies were included: 60 treated with WE, and 81 with IC. Five WE patients (8%) suffered LR whereas 25 IC patients (31%) did. The odds of LR were three times less in the WE group vs the IC group. MSTS1993 scores, where available, were on average 'good' with WE and 'excellent' with IC. Conclusions: Within statistical limitations the data support an attempt, where feasible, at wrist joint preservation and superior function with IC. Intralesional curettage is reasonable when the functional benefit outweighs the risk of recurrence as is the case in many cases of GCT of the distal radius.

scholarly journals Successful Treatment with Denosumab of a Giant Cell Tumor of Bone in the Iliac Bone of an 84-Year-Old Man

2020 ◽  
Vol 63 (3) ◽  
pp. 228-233
Author(s):  
Kensaku Yamaga ◽  
Satoshi Kuwamoto ◽  
Daichi Mukunoki ◽  
Mari Osaki ◽  
Hideki Nagashima
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Successful Treatment ◽  
Cell Tumor ◽  
Iliac Bone

scholarly journals Giant Cell Tumor of the Capitate Bone

2018 ◽  
Vol 10 (03) ◽  
pp. 158-161 ◽  
Author(s):  
Ahmadreza Afshar ◽  
Ali Tabrizi ◽  
Ali Aidenlou ◽  
Ata Abbasi
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
High Speed ◽  
Cell Tumor ◽  
Intralesional Curettage ◽  
Allogenic Bone ◽  
High Speed Burr ◽  
The Right ◽  
Allogenic Bone Graft ◽  
Capitate Bone

AbstractThis case report describes a 16-year-old female patient with a giant cell tumor in her right capitate bone. The tumor was removed by intralesional curettage. A high-speed burr was used to extend the margins of the curettage, and alcohol irrigation was used for adjuvant therapy. The cavity of the capitate was filled with allogenic bone graft. There was no recurrence after 2 years of follow-up, and the right wrist radiographs demonstrated healing of the lesion.

scholarly journals Locally Aggressive Connective Tissue Tumors

2018 ◽  
Vol 36 (2) ◽  
pp. 202-209 ◽  
Author(s):  
Mrinal M. Gounder ◽  
David M. Thomas ◽  
William D. Tap
Keyword(s):  
Connective Tissue ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Predictive Biomarkers ◽  
Cell Tumor ◽  
Loss Of Function ◽  
Recurrence Rates ◽  
End Points ◽  
Bladder Obstruction ◽  
Patient Reported

In this review, we highlight the complexities of the natural history, biology, and clinical management of three intermediate connective tissue tumors: desmoid tumor (DT) or aggressive fibromatosis, tenosynovial giant cell tumor (TGCT) or diffuse-type pigmented villonodular synovitis (dtPVNS), and giant cell tumor of bone (GCTB). Intermediate histologies include tumors of both soft tissue and bone origin and are locally aggressive and rarely metastatic. Some common aspects to these tumors are that they can be locally infiltrative and/or impinge on critical organs, which leads to disfigurement, pain, loss of function and mobility, neurovascular compromise, and occasionally life-threatening consequences, such as mesenteric, bowel, ureteral, and/or bladder obstruction. DT, PVNS, and GCTB have few and recurrent molecular aberrations but, paradoxically, can have variable natural histories. A multidisciplinary approach is recommended for optimal management. In DT and PVNS, a course of observation may be appropriate, and any intervention should be guided by symptoms and/or disease progression. A surgical approach should take into consideration the infiltrative nature, difficulty in obtaining wide margins, high recurrence rates, acute and chronic surgical morbidities, and impact on quality of life. There are similar concerns with radiation, which especially relate to optimal field and transformation to high-grade radiation-associated sarcomas. Systemic therapies must be considered carefully in light of acute and chronic toxicities. Although standard and novel therapies are promising, many unanswered questions, such as duration of therapy and optimal end points to evaluate efficacy of drugs in clinical practice and trials, exist. Predictive biomarkers and novel clinical trial end points, such as volumetric measurement, magnetic resonance imaging T2 weighted mapping, nuclear imaging, and patient-reported outcomes, are in development and will require validation in prospective trials.

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