Giant Cell Tumor of Bone

Amanatullah, Derek F.; Clark, Tyler; Lopez, Matthew J.; Borys, Dariusz; Tamurian, Robert M.

doi:10.3928/01477447-20140124-08

Cited by 73 publications

(106 citation statements)

References 63 publications

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“…A GCT of the long bones is a locally aggressive lesion with a tendency for local recurrence, especially when located at the distal end of the radius [2,26]. The primary aim of treatment of GCTs of the distal radius is to completely remove the tumor, reduce the chances of recurrence, and retain maximum possible function of the involved wrist.…”

Section: Discussionmentioning

confidence: 99%

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What are the Functional Results, Complications, and Outcomes of Using a Custom Unipolar Wrist Hemiarthroplasty for Treatment of Grade III Giant Cell Tumors of the Distal Radius?

Wang

Liu

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Purpose A giant cell tumor (GCT) of bone presenting in the distal radius is rare, however, when they occur, Campanacci Grade III tumors can present formidable reconstructive challenges. They are associated with a high local recurrence rate with intralesional treatment, therefore approaches to reconstruct the wrist after en bloc resection warrant study. Questions We asked: (1) What are the functional outcomes after en bloc resection and reconstruction of the wrist with a unipolar prosthesis in patients with Grade III GCT of the distal radius? (2) What complications occur with use of a unipolar prosthesis in these patients? (3) What are the oncologic outcomes with using en bloc resection and reconstruction with a custom unipolar wrist hemiarthroplasty for Grade III GCTs of the distal radius? Methods We retrospectively analyzed 10 patients with Campanacci Grade III GCTs of the distal radius treated by a unipolar prosthesis after wide resection of the tumor between January 2008 and October 2013. During that period, all patients at our medical group who presented with a Grade III GCT of the distal radius were treated with wide resection and reconstruction using a custom unipolar implant. Pre-and postoperative pain at rest were assessed according to a 10-cm VAS score. The functional outcomes of the wrist were assessed using the modified Mayo wrist score, and the degenerative changes were evaluated radiographically by a new rating system based on the Knirk and Jupiter scale. We also analyzed tumor recurrence, metastases, and complications associated with the reconstruction procedure. All patients were available for followup at a mean of 52 months (range, 24-90 months). Results Although the complication rate associated with prosthetic arthroplasty was relatively high (six of 10), none of our patients experienced severe complications. Two patients reported having occasional pain of the involved wrist at the time of final followup (VAS, preoperative versus postoperative: 0 versus 3; 5 versus 2, respectively). The mean modified Mayo wrist score was 68 (range, 45-90). Degenerative changes were found in three wrists (Grade 1, two patients; Grade 2, one patient). Aseptic loosening occurred in one patient and wrist subluxation occurred in two patients. Lung metastases or local tumor recurrence were not observed. Conclusions Because of the proportion of patients who had complications and progressive degeneration with this approach, we recommend first exploring alternatives to reconstruction with custom unipolar wrist hemiarthroplasty after resection of Grade III GCTs of the distal radius, such as fibular autografting. However, this technique provides an alternative for patients with concerns regarding possible morbidity associated with autografting, and for situations when allograft is not available.

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Section: Discussionmentioning

confidence: 99%

“…A giant cell tumor (GCT) of bone is a benign lesion, usually epiphyseal in location, in patients in the 20-to 40-year age group [2,24]. It is locally aggressive with a tendency for local recurrence (20%-50%) and a low incidence of lung metastases (2%) [5,10,13].…”

Section: Introductionmentioning

confidence: 99%

What are the Functional Results, Complications, and Outcomes of Using a Custom Unipolar Wrist Hemiarthroplasty for Treatment of Grade III Giant Cell Tumors of the Distal Radius?

Wang

Liu

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…The most common symptom in the early stage of the disease is localized pain combined with a visible or palpable mass, sometimes with rapid growth [4,5,8]. The most involved sites in decreasing order of frequency are the distal femur, proximal tibia, proximal femur, distal radius and distal tibia [4,5].…”

Section: Discussionmentioning

confidence: 99%

“…Around 60% of the cases of GCTB affect women, with 70-80% of them typically during the third or fourth decades of life, when skeletal maturity is reached [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

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Metastatic Giant Cell Tumor of Bone: A Case Report

et al. 2014

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Giant cell tumor of bone is a relatively rare primary bone neoplasm. It was originally classified as benign tumor; however, it rarely presents as aggressive disease with the potential to distant metastasis mainly in lung. The objective of this study was to present and discuss a case of metastatic giant cell tumor. A young female patient with a recent history of resected bone lesion, hospitalized with dyspnea, was investigated and extensive lung metastasis was found. She received one cycle of chemotherapy until availability of molecular targeted therapy; however, she died due to disease complications 1 day after introduction of denosumab. This rare neoplasm is slightly predominant in females, typically occurring during the third or fourth decades of life, when bone maturity is reached. Accurate diagnosis is given by histopathological analysis. Microscopically the neoplasm is characterized by the presence of multinucleated giant cells of osteoclast type amid a richly vascular stroma of mononuclear cells. The standard treatment is curettage, filling with cement (polymethylmethacrylate) or bone graft. The possibility of recurrence is significant, and 15-50% of cases are treated with simple curettage. In cases where surgery is not possible, the systemic treatment can be attempted. The choice of the treatment regimen is based on case reports or series of cases. Recently a promising targeted therapy emerged, denosumab, a monoclonal antibody directed to the RANK ligand-L. In our case, besides the severity of the disease, inadequate follow-up after surgery and delayed access to specialized services may have contributed to the outcome.

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Increased Risk of Lung Metastases in Patients with Giant Cell Bone Tumors: A Systematic Review

Yayan

2019

Advances in Experimental Medicine and Biology

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Giant Cell Tumor of Bone

Cited by 73 publications

References 63 publications

What are the Functional Results, Complications, and Outcomes of Using a Custom Unipolar Wrist Hemiarthroplasty for Treatment of Grade III Giant Cell Tumors of the Distal Radius?

What are the Functional Results, Complications, and Outcomes of Using a Custom Unipolar Wrist Hemiarthroplasty for Treatment of Grade III Giant Cell Tumors of the Distal Radius?

Metastatic Giant Cell Tumor of Bone: A Case Report

Increased Risk of Lung Metastases in Patients with Giant Cell Bone Tumors: A Systematic Review

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