Multicentric giant cell tumor around the knee

Abstract

A case of multicentric giant cell tumor with synchronous occurrence in all three bones around the knee is reported here in view of its rarity. A 33-year-old average built male reported with complaints of severe pain, gradually increasing swelling around the right knee. A 3 × 2 cm swelling was present on the lateral aspect of the distal end of the right femur and a 3 × 3 cm swelling on the proximal part of the right tibia. Plain X-ray of right knee showed subarticular eccentrically located expansile lytic lesion in the lateral tibia condyle, lateral condyle of femur and patella. Fine needle aspiration cytology and subsequent histology ascertained the diagnosis of giant cell tumor of the bone. The patient was treated successfully with curettage, bone grafting and methyl methacrylate cementing (Sandwich technique).

Multicentric Giant Cell Tumor of Bone: Synchronous and Metachronous Presentation

“…Approximately 100 cases have been reported worldwide, mostly single case descriptions or studies of small series [3–5, 7–15]. …”

“…Synchronous tumors occur less frequently than metachronous tumors [1–3, 5]. If a second tumor develops more than six months after the first lesion, the lesions are classified as metachronous.…”

“…The preferred treatment method is intralesional curetting and filling the cavity with bone cement [1, 3, 5, 6, 8]. Since the detection of recurrent lesions is enhanced by the use of bone cement it is considered more appropriate than the use of primary bone graft.…”

“…Since the detection of recurrent lesions is enhanced by the use of bone cement it is considered more appropriate than the use of primary bone graft. Thermal cauterization of the bone cement, by its exothermic reaction in combination with local chemical cauterization using phenol may help destroy microscopic tumor cells and reduce the chance of recurrence [1, 5]. …”

“…This occurrence of multicentric lesions developing after an osteosarcoma and the well-documented tendency of multicentric tumors to affect younger patients [3, 5, 9, 11, 13] suggest that there may be a germ-line genetic abnormality that predisposes these patients to the development of multiple tumors, but familial forms of multicentric GCTs of bone have not been reported [3]. …”