Giant Cell Tumor With Pathologic Fracture: Should We Curette or Resect?

Heijden, L. van der; Dijkstra, P. D. Sander; Campanacci, Domenico Andrea; Gibbons, C. L. M. H.; Sande, Michiel A. J. van de

doi:10.1007/s11999-012-2546-6

Cited by 89 publications

(116 citation statements)

References 23 publications

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“…The most widely used adjuvant in the treatment of GCTB is polymethylmetacriylate (PMMA) bone cement (Figure 2b) [2,49,70,78,79]. Packing the defect with bone cement after curettage is advantageous in that it is cheap, allows immediate weight-bearing, and provides optimal radiological conditions to easily identify local recurrences by radiography, CT, and MRI [2,8,49,70,76,78,79].…”

Section: Curettagementioning

confidence: 99%

“…Packing the defect with bone cement after curettage is advantageous in that it is cheap, allows immediate weight-bearing, and provides optimal radiological conditions to easily identify local recurrences by radiography, CT, and MRI [2,8,49,70,76,78,79]. The other option of filling the cavity after curettage is bone grafting.…”

Section: Curettagementioning

confidence: 99%

“…[2,70,78,79]. The advantage is avoiding a complex skeletal reconstruction at an early age, and the disadvantage is a higher risk of recurrence.…”

Section: Curettagementioning

confidence: 99%

“…Promising results have been achieved by the neoadjuvant use of Denosumab which inhibits RANKL [109][110][111]. This therapy induces calcification of the affected soft tissues which allows the extension of the indication for curettage and additional adjuvants [79]. According to Branstetter et al [112] the neoadjuvant use of Denosumab significantly reduced or eliminated RANKpositive tumor giant cells.…”

Section: Molecular Adjuvant Therapy In the Treatment Of Gctbmentioning

confidence: 99%

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Giant cell tumor of bone: current review of morphological, clinical, radiological, and therapeutic characteristics

Georgiev

Slavchev²,

Dimitrova³

et al. 2014

J Clin Exp Invest

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ÖZETKemiğin dev hücreli tümörü erişkinlerdeki tüm primer kemik tümörlerinin %5'ini oluşturur ve kemik tümörlerinin en güç ve yoğun araştırılanıdır. Bu durum büyük ölçüde tekrarları öngörmeye izin veren tek tip klinik, radyografik, histolojik ve morfolojik özelliklerinin olmayışı nedeniyledir. Dünya Sağlık Örgütü tarafından agresif potansiyeli olan malign bir lezyon olarak sınıflandırılan kemiğin dev hücreli tümörü akciğere metastaz yapar ve malign dejenerasyon veya çok merkezli lokalizasyon gösterir. Tümör genellikle uzun kemiklerde oluşur, ancak alışılmadık lokalizasyonlarda da olabilir. Yaygın semptomu tümör bölgesindeki artan ağrıdır. Standart tedavi küretajdan geniş rezeksiyona kadar değişir ve değişik onkolojik ve fonksiyonel sonuçlar doğurur. Tümör evresine bakılmaksızın, cerrahiyi takip eden ilk 2-3 yılda tekrarlama riski yüksektir. Bu yazıda bu patolojik teşekkülün morfolojik, klinik, radyolojik ve tedavi özellikleri ile ayırıcı tanısı tartışılmıştır.Anahtar kelimeler: Kemiğin dev hücreli tümörü, tanı, tedavi, derleme ABSTRACTGiant cell tumor of bone accounts for about 5% of all primary bone tumors in adults and is still one of the most obscure and intensively examined tumors of bone. This largely results from the lack of uniform clinical, radiographic, histological or morphological aspects that allow prediction of recurrence. Classified by the World Health Organization as "an aggressive, potentially malignant lesion", the giant cell tumor of bone could give lung metastases, could undergo malignant degeneration or could have multicentric localization. It usually develops in long bones but can also occur in unusual locations. The common presenting symptom is increasing pain at the tumor site. Standard treatment ranges from curettage to wide resection, with reports of varying oncological and functional results. The recurrence rate is high during the first 2-3 years after surgery regardless of pre-operative tumor stage. Herein, we discuss the morphological, clinical, radiological, and therapeutic characteristics of this pathologic entity as well as its differential diagnosis. J Clin Exp Invest 2014; 5 (3): 475-485

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Section: Curettagementioning

confidence: 99%

Section: Curettagementioning

confidence: 99%

“…[2,70,78,79]. The advantage is avoiding a complex skeletal reconstruction at an early age, and the disadvantage is a higher risk of recurrence.…”

Section: Curettagementioning

confidence: 99%

Section: Molecular Adjuvant Therapy In the Treatment Of Gctbmentioning

confidence: 99%

See 2 more Smart Citations

Giant cell tumor of bone: current review of morphological, clinical, radiological, and therapeutic characteristics

Georgiev

Slavchev²,

Dimitrova³

et al. 2014

J Clin Exp Invest

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show abstract

“…It usually involves the end of a long bone in middle-aged patients. GCTB most commonly occurs in patients 20-40 years of age, and can be found in many sites of the body; however, a half of GCTBs occur around the knee [3,4]. Taking into consideration its unclear biological behavior, high recurrence rate and possible pulmonary metastasizing, GCTB is one of the most controversial and widely discussed bone tumors.…”

Section: Introductionmentioning

confidence: 99%

Significance of β-catenin expression for the incidence of pathological fractures in giant cell tumors of bone

Sopta¹,

Lujic²,

Kovacevic³

et al. 2016

pjp

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Aim of the study is to determine the possible roles of p53, cyclin D1, B-catenin and Ki-67 in the increase in risk of fractures in patients with giant cell tumor of bone. The study included a total of 164 patients with giant cell tumor of bone (GCTB), 21 (12.8%) with and 143 (87.2%) without fracture. The samples were analyzed immunohistochemically for expression of Ki-67, p53, cyclin D1 and b-catenin. According to the immunohistochemical expression of p53 and Ki-67 in mononuclear stromal cells, as well as of cyclin D1 in multinuclear giant cells, there was no significant association with immunopositivity and risk of fractures. However, our research revealed that patients with cytoplasmic expression of b-catenin in stromal cells had three times more frequent occurrence of pathological fractures, which was highly statistically significant (χ 2 = 7.065; p = 0.008). Moreover, a highly statistically significant correlation between the nuclear expression of b-catenin in giant cells and the incidence of pathological fractures was also found (χ 2 = 8.824; p = 0.003). The study showed that b-catenin expression highly correlates with the incidence of pathological fractures in patients with GCTB. Taking into account that b-catenin is closely linked to activation of the Wnt signaling pathway in GCTB pathogenesis, one could postulate that activation of the Wnt pathway is one of the contributing factors to locally destructive behavior of this tumor, as well as to the incidence of pathological fractures.

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Salvage of the proximal femur following pathological fractures involving benign bone tumors

Carvallo

Griffin

Ferguson

et al. 2015

Journal of Surgical Oncology

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Giant Cell Tumor With Pathologic Fracture: Should We Curette or Resect?

Abstract: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Cited by 89 publications

References 23 publications

Giant cell tumor of bone: current review of morphological, clinical, radiological, and therapeutic characteristics

Giant cell tumor of bone: current review of morphological, clinical, radiological, and therapeutic characteristics

Significance of β-catenin expression for the incidence of pathological fractures in giant cell tumors of bone

Salvage of the proximal femur following pathological fractures involving benign bone tumors

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