Metachronous Multicentric Giant Cell Tumor: A Case Report and Literature Review

Haskell, Andrew; Wodowoz, Olga; Johnston, James O.

doi:10.1097/01.blo.0000068770.86536.e1

Cited by 28 publications

(19 citation statements)

References 45 publications

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“…Similar results have already been published (Ghert et al 2002, Haskell et al 2003. Thus, we do not advocate patient follow-up after 5 years of recurrence-free observation.…”

Section: Discussionsupporting

confidence: 74%

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Cement is recommended in intralesional surgery of giant cell tumors: A Scandinavian Sarcoma Group study of 294 patients followed for a median time of 5 years

Kivioja¹,

Blomqvist

Hietaniemi³

et al. 2008

Acta Orthopaedica

210

205

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Background Giant cell tumors of bone rarely metastasize but often recur locally after surgery. There is limited knowledge about the risk of recurrence related to different types of treatment.Patients and methods We analyzed factors affecting the local recurrence rate in 294 patients with giant cell tumors of the extremities using prospectively collected material from 13 centers. The median follow-up time was 5 (0.2-18) years.Results A local recurrence was diagnosed in 57 of 294 patients (19%). The overall 5-year local recurrence rate was 0.22. Univariate analysis identified young age and intralesional surgery to be associated with a higher risk of recurrence. Based on multivariate analysis, the relative risk was 2.4-fold for intralesional surgery compared to more extensive operative methods. There was no correlation between tumor size, tumor extension, sex of the patient, tumor location, or fracture at diagnosis and outcome. In the subgroup of 200 patients treated with intralesional surgery, the method of filling (cement or bone) was known for 194 patients and was statistically highly significant in favor of the use of cement.Interpretation Intralesional surgery should be the first choice in most giant cell tumors, even in the presence of a pathological fracture. After thorough evacuation, the cavity should be filled with cement.

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“…Similar results have already been published (Ghert et al 2002, Haskell et al 2003. Thus, we do not advocate patient follow-up after 5 years of recurrence-free observation.…”

Section: Discussionsupporting

confidence: 74%

“…phenol, alcohol, sterile water, heat, freezing, zinc, and hydrogen peroxide (Nicholson et al 1998, Malawer et al 1999, Trieb et al 2001, Ghert et al 2002, Ward and Li 2002, Haskell et al 2003, Zhen et al 2004. Recently, argon laser therapy has been added to the list (Lewis et al 2007).…”

Section: Discussionmentioning

confidence: 99%

Cement is recommended in intralesional surgery of giant cell tumors: A Scandinavian Sarcoma Group study of 294 patients followed for a median time of 5 years

Kivioja¹,

Blomqvist

Hietaniemi³

et al. 2008

Acta Orthopaedica

210

205

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“…In our series as well as in the former literature approximately 1% of GCTB present as multiple synchronous or metachronous lesions (Haskell et al 2003;Hindman et al 1994;Hoch et al 2006;Leggon et al 2004;Taraporvala et al 1997;Taylor et al 2003). As reported by several authors, patients with multicentric GCTB are likely to be younger than those with a solitary lesion (Hindman et al 1994;Hoch et al 2006).…”

Section: Multifocal Gctbsupporting

confidence: 53%

Giant cell tumor of bone: treatment and outcome of 214 cases

Balke

Schremper

Gebert

et al. 2008

J Cancer Res Clin Oncol

378

414

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The combination of all adjuncts (PMMA, burring, H(2)O(2) - n = 42) reduces the likelihood of recurrence by the factor 28.2 compared to curettage only and therefore should be recommended as a standard treatment. If the tumor reaches close to the articulating surface a subchondral bone graft (n = 42) can be performed without risking a higher recurrence rate. We add seven cases of pulmonary metastases and two cases of multicentricity to the literature. Bisphosphonates and interferon alpha may have a beneficial effect.

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“…Multicentric GCTs are extremely rare and represent less than 1% of GCTs [32]. Fewer than 60 cases have been reported in the literature [2,3,7,8,9,10,11,12,13,14,15,16,17,19,20,21,22,23,24,25,26,27,29,30,31,33,35,36]. Therefore, the pathogenesis of multiple benign lesions is still a matter of debate [22].…”

Section: Introductionmentioning

confidence: 98%

Metachronous multicentric giant-cell tumor of the bone in the lower limb. Case report and Ki-67 immunohistochemistry study

et al. 2003

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Multicentric giant-cell tumors of the bone (GCTs) are rare. Little is known about the mechanisms by which these tumors spread and how 1% of GCT turn out to be multicentric. We report the case of a 19-year-old woman with metachronous multiple and recurrent GCTs that were unusual in their pattern of progression along the right lower limb over a 23-year period. Histology showed no evidence of malignant transformation. The treatment was repeated curettage and packing with cement. This did not permit a wide surgical margin, but avoided amputation and preserved full limb function. We tested the proliferation index marker Ki-67 in the tumor specimens. Ki-67 expression was limited to the mononuclear cell component of the tumors. The proliferation index was similar in each new tumor and higher in recurrences for each location. In this case, proliferation was initially low in the new tumor location, despite the time difference and independent from the initial clone evolution. Proliferation index increased in recurrent GCTs after marginal margin resection.

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Metachronous Multicentric Giant Cell Tumor: A Case Report and Literature Review

Cited by 28 publications

References 45 publications

Cement is recommended in intralesional surgery of giant cell tumors: A Scandinavian Sarcoma Group study of 294 patients followed for a median time of 5 years

Cement is recommended in intralesional surgery of giant cell tumors: A Scandinavian Sarcoma Group study of 294 patients followed for a median time of 5 years

Giant cell tumor of bone: treatment and outcome of 214 cases

Metachronous multicentric giant-cell tumor of the bone in the lower limb. Case report and Ki-67 immunohistochemistry study

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