Surgical Treatment of Multifocal Giant Cell Tumor of Carpal Bones With Preservation of Wrist Function: Case Report

Giant cell tumor of the capitate

“…Due to the rarity and the lack of a large series reporting on GCT of bone in the hand, there is no standard surgical procedure and uniformly accepted treatment. Excisional procedures including marginal or wide resection, and intralesional surgery have been reported [7,8,10,11,14]. Adjuvant treatments used after excision of GCT of bone in the hand, as in the present case, include cryosurgery and phenol ablation [13,17,18,22].…”

“…Adjuvant treatments used after excision of GCT of bone in the hand, as in the present case, include cryosurgery and phenol ablation [13,17,18,22]. The local recurrence rate for tumors initially treated with curettage and bone grafting was 87% at a mean of 20 months (range, 3-48 months) [6,7,10,14]. It is unclear whether this is due to a real difference in biological behavior, or it is simply related to the difficulty of accomplishing complete curettage in the small bones of the hand maintaining its structural and functional integrity [8].…”

“…The diagnosis of GCT of bone in the hand is difficult [3][4][5][6][7][8][9][10]. Histologically, GCT of bone is characterized by multinuclear giant cell aggression on cellular fibrous biological stromal tissue of greater density, multiple hemorrhagic foci, and sporadic calcifications.…”

Giant Cell Tumor of the Capitate Treated with Excision and Midcarpal Fusion

“…Only 11 cases of GCT of the capitate bone were reported. [2][3][4][5][6][7][8][9][10] In 9 of 11 cases, the radiographic stage according to the Campanacci et al grading system 8 was found (►Table 1). Details of age, gender, radiographic stage, treatment, and, when available, evolution of these 11 cases are given in ►Table 2.…”

“…All these patients recovered a useful range of motion. After wide resection, authors reported no need for reconstruction with excellent function (patient 3 in ►Table 2), 6 or carpometacarpal arthrodesis with iliac corticocancellous bone graft 3,4,7 . One patient recovered good function (patient 5 in ►Table 2), and one patient recovered 60% of the wrist motion (patient 2 in ►Table 2) 7 ; other patients recovered 90 degrees of flexion and extension of the wrist, with normal pronosupination (patients 9 and 10 in ►Table 2).…”