Multicentric Giant Cell Tumor of the Fourth and Fifth Metacarpals with Lung Metastases

Naam, Nash H.; Jones, Steven; Floyd, Justin D.; Memisoglu, Esat

doi:10.1007/s11552-013-9574-x

Cited by 15 publications

(17 citation statements)

References 19 publications

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“…G iant cell tumor of bone (GCTB), accounting for 4%-5% of all primary bone tumors, has been recognized as a locally aggressive tumor with or without multi-centric lesions 29,30 . Distant metastasis occurs at a low rate [1][2][3][4][5][6] .…”

Section: Discussionmentioning

confidence: 99%

Selective Arterial Embolization for the Treatment of Sacral and Pelvic Giant Cell Tumor: A Systematic Review

Sun

et al. 2017

Orthopaedic Surgery

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Giant cell tumor of the bone (GCTB) is a locally aggressive tumor with a certain distant metastatic rate. For sacral GCT (SGCT) and pelvic GCT (PGCT), surgery has its limitations, especially for unresectable or recurrent tumors. Selective arterial embolization (SAE) is reported to be an option for treatment in several cases, but there are few systematic reviews on the effects of SAE on SGCT and/or PGCT. Medline and Embase databases were searched for eligible English articles. Inclusion and exclusion criteria were conducted before searching. All the clinical factors were measured by SPSS software, with P-values ≤0.05 considered statistically significant. A total of 9 articles were retrieved, including 44 patients receiving SAE ranging from 1 to 10 times. During the mean follow-up period of 85.8 months, the radiographic response rate was 81.8%, with a local control and overall survival rate of 75% and 81.8%, respectively. No bowel, bladder, or sexual dysfunction was observed. Three patients developed distant metastases and finally died. Patients with primary tumors tended to have better prognosis than those with recurrence (P = 0.039). The favorable outcomes of SAE suggest that it may be an alternative treatment for SGCT and PGCT patients for whom surgery is not appropriate.Key words: Local control; Overall survival; Pelvis; Sacral giant cell tumor; Selective arterial embolization Introduction G iant cell tumor of bone (GCTB) is defined as a potential locally aggressive tumor with a distant metastatic rate of approximately 6.6% [1][2][3][4][5][6] . It occurs most in the second to fourth decades of young adults, but also can be found in patients at any other period. Morbidities between men and women are almost equal. Epiphysis and metaphysis of long bones are the most prevalent sites among the GCT occurrence sites, especially at the distal femur and proximal tibia. Sacral giant cell tumor (SGCT) is the third most common GCTB. SGCT accounts for 2%-8% of all GCTB cases, while pelvic giant cell tumors (PGCT) are less frequent [7][8][9][10][11] . Pain is the most common complaint due to the osteolytic destruction. Other clinical manifestations include pathological fracture, losing control of bladder and bowel, as well as sexual dysfunction. Pathological fracture is generally considered as a potential predictor of higher local recurrence and distant metastases rate. GCTB are usually a solid brown mass. Histologically, they contain substantial multinucleated osteoclastlike giant cells and mononuclear stromal cells. According to their radiological appearance, GCTB are classified by Campanacci et al. 5 into three grades: Stage I, latent; Stage II, active; and Stage III, aggressive.Although surgery remains the treatment of choice for local SGCT, it is limited by a high recurrence rate and heavy surgical bleeding due to the complex anatomic structures, regardless of wide excision or intralesional curretage 8,12 . In addition, neurological dysfunction at the expense of incontinence and sexual dysfunction could lead to psychol...

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Section: Discussionmentioning

confidence: 99%

Selective Arterial Embolization for the Treatment of Sacral and Pelvic Giant Cell Tumor: A Systematic Review

Sun

et al. 2017

Orthopaedic Surgery

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“…Cases of dissemination at a distance have been described, with special incidence at the pulmonary level. Although these metastases are usually benign, a follow-up of at least three years is recommended [6]. Recurrence rates of upto 10% are described in ray amputation [7], but the resulting morbidity is something that weighs heavily on the patient's decision.…”

Section: Discussionmentioning

confidence: 99%

“…Reviewing the literature, and especially considering the first ray, the are several accounts of techniques that involve resection and reconstruction with autologous graft from the fibula, iliac crest or metatarsals [2,6]. Regarding the metacarpophalangeal joint, arthrodesis and the use of silicone prostheses have been described, but especially in young and active patients, these options do not yield in most cases, a good functional result [3,6].…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of the Second Metacarpal Bone after Bone Tumor Resection with Free Fibular Graft

Fernandes¹,

Almeida²,

Lopes³

et al. 2018

JCR

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Background: Bone giant cell tumors are rarely found on the hand. Several treatments have been described but only the resection/ amputation of the affected segment can offer an effective cure in advanced cases. Various forms of reconstruction have been described, namely using a free graft of fibula. Case Report: The authors present a case of a man with an osteolytic and expansive lesion of the distal end of the second metacarpal that was treated with resection and autologous free fibular graft with good clinical and radiologic outcome. Conclusion: Free fibular graft is a possible solution to avoid ray amputation in cases of bone tumors in the metacarpals.

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“…Most GCTB lung metastases are benign, whereas others may spontaneously regress or progress and cause death. 22 Continuous follow-up for at least 3 years is essential to prevent undesirable sequelae.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of an Entire Thumb Metacarpal

Lim

Babineaux

2016

Plastic and Reconstructive Surgery - Global Open

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Summary:This case report discusses the reconstruction of an entire thumb metacarpal after a diagnosis of giant cell tumor of bone. The patient underwent excision of the entire thumb metacarpal, followed by interposition of a tricortical iliac crest bone graft and metacarpophalangeal and carpometacarpal joint arthrodeses. This option allowed salvage of the patient’s native thumb with functional use as a stable post to which she can pinch and grasp objects. At 9 months postoperatively, there was no evidence of recurrence.

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Multicentric Giant Cell Tumor of the Fourth and Fifth Metacarpals with Lung Metastases

Cited by 15 publications

References 19 publications

Selective Arterial Embolization for the Treatment of Sacral and Pelvic Giant Cell Tumor: A Systematic Review

Selective Arterial Embolization for the Treatment of Sacral and Pelvic Giant Cell Tumor: A Systematic Review

Reconstruction of the Second Metacarpal Bone after Bone Tumor Resection with Free Fibular Graft

Reconstruction of an Entire Thumb Metacarpal

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