The primary malignant gcts are rare where a giant cell tumorlike area exists alongside a highgrade sarcoma. Giant cell tumors gcts of the distal radius are lowgrade malignant lesions that are locally aggressive and can metastasize to the lung and bone. It is characterized by the presence of multinucleated giant cells osteoclastlike cells. Osteoarticular allograft reconstruction of the distal radius. Distal radius lesion most in keeping with giant cell tumor with evidence of local extension into the extensor compartment. Intraoperative photograph of resection bed of same giant cell tumor of distal radius as in preceding image after distal radius is resected. Giantcell tumor of the bone gctob, is a relatively uncommon tumor of the bone. Giantcell tumor of the distal ulna treated by wide resection. En bloc excision and autogenous fibular reconstruction for. These would more appropriately be termed as giant cell rich sarcomas and should be treated on similar lines as a primary bone sarcoma. The tumor is generally benign and characterized histologically by multinucleated giant cells with a background of mononuclear stromal cells. The tumour is one of low metastatic potential with the percentage of recurrence being close to 2040%. Kapandji procedure using the iliac bone graft, preserving the. A giant cell tumor of bone is a type of benign noncancerous tumor that grows at the ends of the bodys long bones.
Marcove, md, new york, ny we compared the outcome of patients with giant cell tumor of the distal radius treated by curet tagecryosurgery and en bloc resection, evaluating oncologic success, functional results, and complications. Several reconstructive procedures like vascularized and nonvascularized fibular graft, osteo. A 23yearold male had a giant cell tumor occurred in the distal end of the ulna. It is locally aggressive with tendency for local recurrence1. Giant cell tumor of the bone accounts for 45% of primary bone tumors and 18. Resectionreconstruction arthroplasty for giant cell tumor of. G iant cell tumor gct is a benign, aggressive skeletal neoplasm that commonly affects young adults. Giantcell tumor of the distal ulna treated by wide. Nov 29, 2011 giant cell tumor of distal radius sumroeng neti, m. Which treatment is the best for giant cell tumors of the. Giant cell tumor of distal radius after open reduction inter.
Giant cell tumor accounts for 5 to 9 percent of all primary bony tumors. Giant cell tumour of the distal radiusayman abdelaziz bassiony 901 patients and methods ten patients with giant cell tumour of the bone at the distal end of the radius were treated between january 2003 and january 2008 at our institution. Based on tumour grading, treatment ltypically ranges. Giantcell tumour of the distal radius is a rare neoplasm that affects the periarticular metaphysial region of the bone.
Giant cell tumors of bone is a primary invasive tumor which has the risk of regional recurrence. It is characterized by local aggressive behaviour and frequent recurrence. Giant cell tumor is a one of the most common primary bone lesions in the distal phalanx. This is very unusual, with a reported incidence of 0. Treatment of giant cell tumor of the distal radius by. Giant cell tumor of bone occurred in the distal end of the ulna is extremely uncommon. To achieve adequate surgical margin, en bloc resection other than intralesional curettage was commonly adopted as a standard surgery for aggressive lesion in. Most often, the tumors develop at the lower end of the femur thighbone or upper end of. A case report and description of surgical technique. After the distal femur and proximal tibia, the distal radius is the third most common location of this tumor 14.
Three cream and haemorrhagic tissue cores with a total length of 40mm. Retrospective analysis of giant cell tumor lower end radius. Giant cell tumor of distal radius treated by enbloc resection and. Most often, the tumors occur close to the knee jointat the lower end of the thighbone femur or the upper end of the shinbone tibia. Intraoperative photograph of same giant cell tumor of. Treatment of giant cell tumor of the distal radius request pdf.
We compared the outcome of patients with giant cell tumor of the distal radius treated by curettagecryosurgery and en bloc resection, evaluating oncologic. Giant cell tumor is a benign aggressive bone tumor of obscure origin presenting in 3 rd and 4 th decade of life, and carries a definite female preponderance. This tumoruslually affects distal femur, proximal tibia or distal radius. One year ago, she was treated at another clinic for a giant cell tumor of the left distal radius. Resectionreconstruction arthroplasty for giant cell tumor of distal. Treatment of giant cell tumor of the distal radius. The distal radius is the third most common location for giant cell tumor gct after the distal femur and proximal tibia, and approximately 10% of gct involve the distal radius 1, 2. Wrist arthrodesis and osteoarticular reconstruction in. Presented is a case of giant cell tumor of the distal radius treated successfully by en bloc resection and translocation of the ipsilateral distal ulna. Clinical effects of three surgical approaches for a giant.
Early diagnosis is the key to less aggressive treatments and with a lower functional deficit. The typical giant cell tumor gct is a solitary neoplasm that occurs in the epiphysis or metaphysis of long bones. Massive wrist prosthesis for giant cell tumour of the distal radius. The distal radius is the third most common site for lesions next to the distal femur and the prox imal tibia.
Giant cell tumor of distal radius sumroeng neti, m. The patient was a 31yearold female who presented with an aching mass on the left distal radius. Giant cell tumor, recurrence, distal end radius, fibular bone graft 1. Jul 31, 2009 the third most common site that giant cell tumours occur is the distal radius, with approximately 10% of cases occurring at that site.
Abstract giant cell tumour of the distal radius is a relatively common tumour. Giant cell tumour gct of the distal fibula is extremely rare and poses challenges in the surgical management. The physical therapist referred the patient to an orthopaedic surgeon, who. Giant cell tumors of bone localized in distal radius. This study evaluates the clinical, radiological and pathological findings in five cases of gctb of the distal forearm where a 3 month course of denosumab was given prior to surgery. Jun 01, 2012 several cases of long bone giant cell tumor have been reported in the literature. However, it is unclear whether one provides lower rates of recurrences and fewer complications, and whether the use of polymethylmethacrylate pmma after curettage reduces the risk of recurrence.
Giant cell tumor or osteoclastoma is a locally aggressive benign tumor accounting for 3%5% of all the primary bone tumors. The aim of the present study was to assess the curative effects of three surgical approaches for a giant cell tumor gct of the distal radius and ulna. However, if malignant degeneration does occur, it is likely to metastasize to the lungs. Distal radius is the third most common site 10% after distal femur and proximal. Giantcell tumor of bone occurred in the distal end of the ulna is extremely uncommon. Malignancy in giant cell tumor is uncommon and occurs in about 2% of all cases. Giant cell tumour, enbloc resection, distal ilna, extensor carpi ulnaris stabilisation introduction giant cell tumour gct of the bone is a rare, benign but locally aggress ive tumour, accounting for 3% to 5% of all primary bone tumours with less than 3% located at the distal ulna 1. We report the case of a patient with a giant cell tumor in the distal ulna.
It is characterized by the presence of multinucleated giant cells osteoclast like cells. Treatment of a recurring giant cell tumor of the distal. Pdf giant cell tumour gct forms 4% of all primary tumours. Giant cell tumor of distal radius treated with ulnar. Study included 25 patients of aggressive gct of distal radius, resected and reconstructed using ulnar translocation and wrist arthrodesis. Marcove, md, new york, ny we compared the outcome of patients with giant. Treatment of giant cell tumour of bone gctb of the distal radius ulna poses a surgical challenge, as complex reconstructive surgery may be required.
Case report wrist arthroplasty using an autogenous iliac. Several cases of long bone giant cell tumor have been reported in the literature. Microsurgical reconstruction in limb salvage due to a. The annals of clinical and analytical medicine giant cell tumors in distal radius 2 introduction the giant cell tumor gct of the bone is a benign but locally. Giant cell tumors are common, comprising 1823% of benign bone neoplasms and 49. We believe biopsy is mandatory in presumed giant cell tumours, particularly those affecting the distal radius. Giant cell tumor of distal radius treated with ulnar translocation and wrist arthrodesis. The aim is to analyze the functional outcomes of patients of giant cell tumor gct of distal radius treated with ulnar translocation and wrist arthrodesis.
Giant cell tumor gct of bone is a benign locally aggressive tumor and tends to recur. Giant cell tumor of bone radiology reference article. Wide excision or intralesional curettage, along with adjuvant chemical cauterisation can. A more aggressive behavior and high recurrence rate for both intralesional and exci sional procedures has been noted for giant cell tumors at this site. We report three cases where the imaging raised the. Clinical and radiographic results of reconstruction with. It characteristically presents as a metaphysealepiphyseal lytic lesion and frequently affects the distal radius dr. However, it is unclear whether one provides lower rates of recurrences and fewer. Six of the 12 patients were treated using intralesional curettage with local excision, and the other six patients underwent en bloc r. Reconstruction following en bloc resection of a giant cell tumor of the distal radius using a vascularized pedicle graft of the ulna. The giant cell tumour of the distal radius is usually seen in the middle aged group between 20 and 40 years who are the main bread earners of the family in a.
The giant cell tumour arises most commonly in the proximal tibia and distal tibia followed by the distal radius which occurs in close to about 10% of the giant cell tumour population. The third most common site that giant cell tumours occur is the distal radius, with approximately 10% of cases occurring at that site. It generally occurs in adults between the ages of 20 and 40 years. Osteoarticular allograft reconstruction of the distal. Case report wrist arthroplasty using an autogenous iliac crest for. They almost invariably 9799% occur when the growth plate has closed and are therefore typically seen in early adulthood.
Wrist arthrodesis after resection of a giant cell tumor of the distal radius can be performed using a vascularized free fibular transfer vfft or a nonvascularized structural iliac crest. The recurrence of gcts of the distal radius is mainly on account of the anatomical characteristics 5. They are most commonly seen in patients in the third and fourth decades of life at the metaphysealepiphyseal junction. Giant cell tumor of the bone gctob, is a relatively uncommon tumor of the bone. Giant cell tumour of bone gctb is a benign but locally aggressive neoplasm, accounting for approximately 5% of primary bone tumours 1,2,3. Several reconstructive procedures like vascularized and nonvascularized fibular graft, osteoarticular allograft, ceramic prosthesis and megaprosthesis are in use for substitution of the defect in the distal radius following resection. Giant cell tumour of bcs a benign but locally aggressive neoplasm, accounting for approximately % of primary bone t. The full text of this article is available in pdf format. Distal end of radius is third most common site for gct of long bones and 1% of these metastasize mostly to lungs. After distal femur and proximal tibia, distal radius happens to be the most common site of occurrence for gct 1, 2. Therefore, the giant cell tumor team of china gtoc performed this retrospective study to i evaluate the clinical and radiographic results of en bloc resection and reconstruction of the distal radius with. Giant cell tumor gct of the distal radius poses problems for reconstruction after resection. Giant cell tumor gct of bone was described by cooper and travers in 1818.
Giant cell tumour, enbloc resection, distal ilna, extensor carpi ulnaris stabilisation introduction giantcell tumour gct of the bone is a rare, benign but locally aggress ive tumour, accounting for 3%. The aim of the present study was to assess the curative effects of three surgical approaches. The surgeon performed biopsy of the lesion, confirming the diagnosis of giant cell tumor. Giant cell tumour of distal radius need and deed introduction giant cell tumour is a benign bone tumour which is locally aggressive in nature with high potential of recurrence. Giant cell tumor gct of distal radius follows a comparatively aggressive behaviour. Giant cell tumor of bone is a benign neoplasm of locally aggressive behavior that can even require radical procedures in extreme cases. The most common sites include the distal femur, proximal tibia and distal radius. Pdf managements of giant cell tumor within the distal. The distal end of the radius is one of the common sites of involvement in giant cell tumors gcts with reportedly increased propensity of recurrence. The functional outcomes and complications of different.
Treatment of giant cell tumor of the distal radius by ulnar. Giant cell tumor of distal radius after open reduction. Gold, use of a prosthesis for the distal portion of the radius following resection of a recurrent giantcell tumor, journal of bone and joint surgery a, vol. Resectionreconstruction arthroplasty for giant cell tumor. Giant cell tumor of the distal radius sciencedirect. Early diagnosis is the key to less aggressive treatments and with a lower. It represents approximately 3 % to 5% of all primary bone cancers. Mega prosthesis, giant cell tumour, distal radius, bone tumour. Managements of giant cell tumor within the distal radius. Introduction giant cell tumor is a benign bone tumor, and usually affects young adults.
Bone giant cell tumor gct is a rare, generally benign and locally aggressive tumor. It characteristically presents as a metaphysealepiphyseal lytic lesion and frequently affects the distal. Recurrent giant cell tumor of the distal end radius. The sacrum, distal tibia, proximal humerus, proximal femur, pelvis and proximal fibula are not infrequent sites. Carpus translocation into the ipsilateral ulna for distal radius. Giant cell tumor, distal radius, enbloc resection, reconstruction arthroplasty, proximal, fibular graft. Reconstruction of the distal radius following tumour. The aim is to analyze the functional outcomes of patients of giant cell tumor gct of distal radius treated with ulnar translocation. Giant cell tumour of the distal radiusayman abdelaziz bassiony 901 patients and methods ten patients with giant cell tumour of the bone at the distal end of the radius were treated between. Giant cell tumor of distal radius treated with ulnar translocation and. We report three cases where the imaging raised the possibility of giant cell tumours but biopsy has revealed an altogether more aggressive pathology. Cureus a rare giant cell tumor of the distal fibula and.
A giant cell tumor of bone is a type of benign noncancerous tumor that typically occurs in young adults between the ages of 20 and 40. Several reconstructive procedures like vascularized and non. Giant cell tumor gct of bone is a benign but locally aggressive tumor and the treatment consists of either curettage or en bloc resection of the lesion with subsequent reconstructions. Wrist arthrodesis and osteoarticular reconstruction in giant. Wide excision is the management of choice, but this creates a defect at the distal end of radius. Cytomorphological diagnosis of giant cell tumour of distal. Microsurgical reconstruction in limb salvage due to a giant. Intralesional excision and en bloc resection are used to treat giant cell tumors gcts of the distal radius. A 23yearold male had a giantcell tumor occurred in the distal end of the ulna. Giant cell tumors are usually found in the long bones, most often the distal femur, proximal tibia, and distal radius.
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