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. 2017:3:54.
doi: 10.1051/sicotj/2017041. Epub 2017 Sep 14.

Giant cell tumor of bone revisited

Andreas F Mavrogenis  1 , Vasileios G Igoumenou  1 , Panayiotis D Megaloikonomos  1 , Georgios N Panagopoulos  1 , Panayiotis J Papagelopoulos  1 , Panayotis N Soucacos  1
Affiliations

Giant cell tumor of bone revisited

Andreas F Mavrogenis et al. SICOT J. 2017.

Abstract

Giant cell tumor (GCT) of bone is a locally aggressive benign neoplasm that is associated with a large biological spectrum ranging from latent benign to highly recurrent and occasionally metastatic malignant bone tumor. It accounts for 4-10% of all bone tumors and typically affects the meta-epiphyseal region of long bones of young adults. The most common site involved is the distal femur, followed by the distal radius, sacrum, and proximal humerus. Clinical symptoms are nonspecific and may include local pain, swelling, and limited range of motion of the adjacent joint. Radiographs and contrast-enhanced magnetic resonance imaging (MRI) are the imaging modalities of choice for diagnosis. Surgical treatment with curettage is the optimal treatment for local tumor control. A favorable clinical outcome is expected when the tumor is excised to tumor-free margins, however, for periarticular lesions this is usually accompanied with a suboptimal functional outcome. Local adjuvants have been used for improved curettage, in addition to systematic agents such as denosumab, bisphosphonates, or interferon alpha. This article aims to discuss the clinicopathological features, diagnosis, and treatments for GCT of bone.

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Figures

Figure 1.
Figure 1.
Campanacci et al. [3] grading system for GCT that is based on the radiographic appearance of the tumors. (A) Grade 1 (latent), (B) grade 2 (active), and (C) grade 3 (aggressive).
Figure 2.
Figure 2.
High power histopathologic image shows the characteristic multinucleated giant cells of the GCT (arrows).
Figure 3.
Figure 3.
(A) Anteroposterior radiograph, (B) coronal CT, and (C) three-dimensional CT reconstruction of the right wrist of a 40-year-old man with a recurrent GCT of the distal radius after curettage and PMMA cementation. Wide resection and free vascularized fibula graft distal radius reconstruction were done. (D) Anteroposterior and (E) lateral radiographs of the right wrist show no evidence of local tumor recurrence at 16-year follow-up.
Figure 4.
Figure 4.
(A) Anteroposterior radiograph of the left knee of a 46-year-old man with a GCT of the medial femoral condyle. (B) Anteroposterior radiograph of the left knee seven years after curettage, cauterization, and cementation, in addition to short plate osteosynthesis shows no evidence of local tumor recurrence.
Figure 5.
Figure 5.
(A) Anteroposterior and (B) lateral radiographs, and (C) coronal CT of the right wrist of a 43-year-old man with a GCT of the distal radius. Curettage, cauterization, and PMMA cementation were done. (D) Anteroposterior and (E) lateral radiographs of the right wrist show no evidence of local tumor recurrence at eight-year follow-up.
See this image and copyright information in PMC

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