Giant Cell Tumor with Secondary Aneurysmal Bone Cyst of the Patella: A Case Report

Abstract

A 15-year-old girl presented with pain and swelling on the anterior aspect of the right knee for one year. The radiological evaluation with x-rays and magnetic resonance imaging suggested a benign aggressive lesion of the right patella with a cortical breach. Core needle biopsy of the lesion revealed it to be a giant cell tumor (GCT). She was treated with total patellectomy and end-to-end repair of quadriceps to the patellar tendon. The histopathological report of the whole specimen revealed it to be a GCT with secondary aneurysmal bone cyst (ABC). After 24 months, she was asymptomatic, and there was no evidence of local recurrence or distal metastasis. An extensive review of the literature revealed only four cases of combined GCT with secondary ABC in the patella. Though rare, GCT with secondary ABC of the patella should be kept as a differential diagnosis for anterior knee pain and swelling in young patients. The diagnosis is solely based on histopathological findings. It is imperative to obtain a precise tissue diagnosis in the preoperative period to plan appropriate treatment.

Three-dimensional-printed custom-made patellar endoprosthesis for recurrent giant cell tumor of the patella: A case report and review of the literature

“…To date, total patellectomies have been reported in treating Campanacci grade III GCTB or malignant neoplasms arising from the patella[ 5 , 6 , 8 , 10 , 16 ]. To repair the consequent defect in the extensor mechanism, several reconstruction methods including end-to-end suture of the quadriceps tendon and patellar tendon[ 6 ], allografting[ 5 , 7 , 8 ], and autografting[ 10 , 11 ] have been proposed. Still, each of them has its demerits (Table 1 )[ 5 , 6 , 17 - 19 ].…”

“…To repair the consequent defect in the extensor mechanism, several reconstruction methods including end-to-end suture of the quadriceps tendon and patellar tendon[ 6 ], allografting[ 5 , 7 , 8 ], and autografting[ 10 , 11 ] have been proposed. Still, each of them has its demerits (Table 1 )[ 5 , 6 , 17 - 19 ].…”

“…Several methods for the reconstruction of extensor mechanisms have been applied, such as end-to-end suture of the quadriceps tendon and patellar tendon[ 6 ], allografting[ 5 , 7 - 9 ], and autografting[ 10 - 12 ]. Although these procedures have been reported to lead to reasonable functional outcomes, each has its corresponding disadvantages, such as donor site morbidity, extensor lag, disease transmission, and graft rejection.…”

Reconstruction of the extensor mechanism using polypropylene mesh in a displaced pathological fracture of the patella affected by giant cell tumour

“…Often, these tumours are misdiagnosed as degenerative conditions, leading to overlooked diagnoses. Giant cell tumour in the patella typically manifests as pain and swelling on the anterior aspect of the knee 2 3. While contained lesions can be effectively treated with curettage, preserving the patella, the presence of a displaced pathological fracture complicates treatment.…”

“…This task is critical due to the extensive soft tissue damage, the risk of tumour recurrence and the goal of restoring function 4 5. Various methods, including autograft, allograft, rotational flaps and more recently, polypropylene mesh, have been employed with success 3–8. However, autografts may be insufficient, allografts carry risks of disease transmission and are often scarce, and local flaps require considerable surgical skill and come with the issue of donor site morbidity.…”