A Giant Cell Tumor of the Distal Femur Managed by Excision and Knee Arthrodesis Using a Custom Made Long Intramedullary Interlocking Nail: A Case Report and Review of the Literature

Macwan, Anson Albert; Nanda, Saurav Narayan; Mishra, Debashish; Tuteja, Saurabh; Sandeep, Bodanapu

doi:10.7759/cureus.14810

Cited by 5 publications

(8 citation statements)

References 17 publications

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“…Post-excision of GCT from the subarticular area, reconstruction should provide adequate biomechanical durability, infection resistance, biological healing and keeping intact function of extension of the knee. This is achieved by the total replacement of the knee joint done with a custom prosthesis [ 14 ]. This surgical method comes with a huge cost, longer rehabilitation and chances of infection.…”

Section: Discussionmentioning

confidence: 99%

Limb Reconstruction Using the Ilizarov Technique Following Giant Cell Tumour Excision in the Proximal Tibia of a 19-Year-Old Female: A Case Report

Patil,

Mankar,

Agrawal

2024

Cureus

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Giant cell tumours (GCTs) of the proximal tibia are a relatively uncommon lesion among all benign tumours. They can occur at various sites including distal femur, proximal tibia and distal end radius. Various management modalities of GCTs occurring in the knee joint have been described for reconstruction as well as arthrodesis. We present a case of a 19-year-old adolescent patient with GCT of the proximal tibia with cortical breach with the collapse of the medial articular surface of the tibia. The patient reported experiencing knee pain and swelling for a long duration. Radiological investigations were suggestive of GCT of the proximal tibia with the medial cortical breach and collapse of the medial tibial articular surface. The patient was managed with a resection followed by arthrodesis using intramedullary nails with bone grafting, followed by Ilizarov reconstruction due to osteomyelitis of the surgical site. When dealing with relatively aggressive tumours that have breached the cortex, wide resection of the tumour is required. Following this, the reconstruction procedure must ensure good biomechanical tenacity, biological healing, infection resistance, and intact function of the knee joint extension. One option for achieving this is total knee replacement with a customized prosthesis, though this can be costly. Another option is joint arthrodesis with intramedullary nailing or the Ilizarov fixator, which is strongly supported by the existing literature. This case was managed successfully with the above-described method, and complete healing was observed. In conclusion, periarticular long bone tumours, especially around the knee joint, can be managed effectively with the Ilizarov method. Though it has a few disadvantages, such as a long duration of external fixator, non-compliance, and pin tract infections, it still stands as a viable alternative for limb reconstruction due to its cost-effectiveness and time-tested efficacy.

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Section: Discussionmentioning

confidence: 99%

Limb Reconstruction Using the Ilizarov Technique Following Giant Cell Tumour Excision in the Proximal Tibia of a 19-Year-Old Female: A Case Report

Patil,

Mankar,

Agrawal

2024

Cureus

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“…The aggressiveness of GCTB leads to pathological fractures in 12% of cases. By definition, this tumor has been presented by multinucleated giant osteoclast-like cells, mononuclear spindle-shaped stromal cells and monocytes [1][2][3][4][5][6][7][8]11 . GCTCs account for 5% of all primary tumors and 20% of all bone tumors [1][2][3][4][5][6][7][8][9]11 .…”

Section: Introductionmentioning

confidence: 99%

“…By definition, this tumor has been presented by multinucleated giant osteoclast-like cells, mononuclear spindle-shaped stromal cells and monocytes [1][2][3][4][5][6][7][8]11 . GCTCs account for 5% of all primary tumors and 20% of all bone tumors [1][2][3][4][5][6][7][8][9]11 . This neoplasia affects individuals aged 20 to 45 years with a slight female predominance (1.5:1) and is relatively rare in childhood 5,11,12 .…”

Section: Introductionmentioning

confidence: 99%

A rare case of neglected long-term pathologic fracture of the distal femur due to a giant cell tumor of bone

Kostadinov

Manolov²,

Георгиев

et al. 2023

JBOTA

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Giant cell tumor of bone is a histologically benign bone neoplasia that clinically has an aggressive course. In rare cases, it can give "benign" lung metastases or undergo malignant transformation. The World Health Organization defines this neoplasia as an "aggressive, potentially malignant lesion". Herein, we present a rare case of a neglected long-term pathologic fracture of the distal femur in a 20-year-old female patient. After a biopsy, a giant cell tumor of bone was diagnosed. The patient was treated with intralesional curettage, osteoplasty and plate fixation of the fracture. Eight months postoperatively, no local recurrence or metastasis of the tumor was observed.

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“…Treatment is usually done surgically as the tumor is excised. Amputation, bone grafting, and bone reconstruction are also used as surgical options for treating patients [ 7 ]. Radiation therapy is mainly used in recurrence, as palliative or in cases that cannot be operated on due to other comorbidities [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

A Young Male With an Active Giant Cell Tumor: A Case Report

Thakur¹,

Deshpande²

2022

Cureus

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A giant cell tumor (GCT) is a benign but locally aggressive tumor usually present over the knee joint. Its etiology is unknown but some studies have shown that it appears due to overexpression in RANK/RANKL by neoplastic mononuclear stromal cells signaling pathway, which results in hyperproliferation of osteoclasts. This is a case of a 25-year-old male who presented with swelling associated with pain over his left distal femur since eight months. The range of motion (ROM) at the knee joint was painful from 0 to 110 degrees and no knee effusion was observed. Examination revealed a slightly mobile mass present over the knee joint. Additional preoperative workup such as Computed Tomography (CT) scan and Magnetic Resonance Imaging (MRI) was done. Histopathological findings showed the presence of large multinucleated osteoclast-like giant cells. Radiographs showed a permeative lytic lesion within the distal femur with surrounding cortical destruction. Surgical excision by curettage and bone grafting was done. The patient did well, without clinical recurrence at one-year follow-up. A local recurrence rate of 2.5 to 45% is observed. Aggressive operative excision, use of adjuvants at the time of resection, and ongoing postoperative monitoring can decrease patient morbidity.

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A Giant Cell Tumor of the Distal Femur Managed by Excision and Knee Arthrodesis Using a Custom Made Long Intramedullary Interlocking Nail: A Case Report and Review of the Literature

Cited by 5 publications

References 17 publications

Limb Reconstruction Using the Ilizarov Technique Following Giant Cell Tumour Excision in the Proximal Tibia of a 19-Year-Old Female: A Case Report

Limb Reconstruction Using the Ilizarov Technique Following Giant Cell Tumour Excision in the Proximal Tibia of a 19-Year-Old Female: A Case Report

A rare case of neglected long-term pathologic fracture of the distal femur due to a giant cell tumor of bone

A Young Male With an Active Giant Cell Tumor: A Case Report

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