Hip joint remodeling in an adult following excision of a giant cell tumor involving the acetabulum: a case report and literature review

Abstract

We describe a 47-year-old man with a giant cell tumor of bone involving the acetabulum treated with curettage and bone grafting which resulted in good remodeling of the hip joint. The patient had a 15 x 18-cm(2) mass lesion extending from the right ischium to the acetabulum. Treatment included curettage, phenol, and ethanol application as an adjuvant, and cancellous bone allografting was performed on the subchondral area of the acetabulum. The posterior column of the acetabulum was disappeared by tumor invasion. Despite central migration of the femoral head, adequate hip joint repair was achieved without surgery 5.5 years postoperatively and with no tumor recurrence. The patient could walk without pain or ambulation aids; hip range of motion was 100 degrees for flexion, 0 degrees for extension, 30 degrees for abduction, 45 degrees for external rotation, and 10 degrees for internal rotation, and the functional result was 93.3% in the Enneking scoring system. We performed intralesional curettage with phenol and ethanol adjuvant therapy for pelvic giant cell tumor without tumor recurrence, and good repair of a hip joint adaptation can be achieved even in an adult patient.

Use of extended curettage with osteotomy and fenestration followed by reconstruction with conservation of muscle insertion in the treatment of Enneking stage II locally aggressive bone tumor of the proximal extremities: resection and treatment of bone tumors

“…These findings indicate that successful treatment of locally aggressive bone tumors of Enneking stage II is possible using these methods in practical clinical settings. In the current study, the postsurgical recurrence rate was 13.3% (two out of fifteen), much lower than the postsurgical recurrence reported by several similar studies [3,11,12,14]. Therefore, IC may also effectively reduce the postsurgical local recurrence of bone tumors of each of these types.…”

“…Recently, biotherapy with receptor activator of nuclear factor kappa-B ligand monoclonal antibodies and colony-stimulating factor 1 signaling pathway inhibitor has been introduced for clinical treatment of GCT [13], though optimal clinical treatment still depends on surgery. Conventional intralesional curettage has been reported to result in recurrence rates higher than 30% in GCT [12,14], whereas wide excision or segmental tumor resection has been reported to produce much lower recurrence rates of only 7% to 10%. These methods, however, require complex bone and soft tissue repair and reconstruction combined with revision surgery following segmental resection of tumors.…”

“…These methods, however, require complex bone and soft tissue repair and reconstruction combined with revision surgery following segmental resection of tumors. Thus, the high rate of complications associated with these procedures necessitates careful consideration of the risk of recurrence versus maximum conservation of joint function [14,15]. …”

An acetabular-preserving procedure for pelvic giant cell tumor involving partial acetabulum

“…A variety of complications such as wound infection, nonunion, bone absorption, deep infection, or hardware failure are obvious; this leads to poor hip function. Until now, few publications have specifically addressed pelvic GCTs involving the region III with partial acetabulum extension [ 2 , 4 , 5 , 7 , 16 – 20 ] (Table 2 ). It remains a challenge to musculoskeletal oncologists on how to balance minimizing the recurrence rates and maximizing the hip functional outcomes.…”