Surgical management of giant cell tumor in adolescent by excision or curettage followed by fibular strut graft
Keywords:Giant cell tumor, Excision, Curettage, Fibular strut graft
Giant cell tumour (GCT) in adolescent is a rare tumour. It commonly occurs in skeletally mature patients aged between 20-40 years. In adults it is seen in epiphyseal region. In patients with intact physis, it arises from the metaphysis. Giant cells are more common in females. It is more common in the ends of long bones of distal end of femur, proximal tibia, and distal radius. 14 cases of surgical management of GCT by excision or curettage in adolescent followed by fibular strut graft. 1 year follow up of all cases of GCT in adolescent treated with excision or curettage followed by fibular strut graft was done. Out of 14 patients, 12 patients did not develop any recurrence of GCT. 2 patient developed recurrence after 6 months. All the patients were able to attain good range of movements 2 months after surgery. GCT in adolescent surgically treated with excision or curettage followed by fibular graft had excellent results in terms of recovery of daily activities, wound healing. Chances of recurrence more in patients treated with curettage and bone grafting.
Anract P, De-Piueus G, Cottias P, Puillart P, Forest M, Tomeno B. Malignant giant-cell tumor of bone. Clinico-pathological types and prognosis: a review of 29 cases. Int Orthop. 1998;22:19-26.
Antal I, Sápi Z, Szendrői M. The prognostic significance of DNA cytophotometry and proliferation index (Ki-67) in giant cell tumors of bone. Int Orthop. 1999;23:315-9.
Balke M, Schremper L, Gebert C, Ahrens H, Streitbuerger A, Koehler G, Hardes J, Gosheger G. Giant cell tumor of bone: treatment and outcome of 214 cases. J Cancer Clin Oncol. 2008;134:969-78.
Becker WT, Dohle J, Bernd L, Braun A, Cserháti M, Enderle A, et al. Local recurrence of giant cell tumor of bone after intralesional treatment with and without adjuvant therapy. J Bone Joint Surg Am. 2008;90-A:1060-7.
Blackley HR, Wunder JS, Davis AM, White LM, Kandel R, Bell RS. Treatment of giant-cell tumors of long bones with curettage and bone-grafting. J Bone Joint Surg Am. 1999;81-A:811-20.
Tse LF, Wong KC, Kumta SM, Huang L, Chow TC, Griffith JF. Bisphosphonates reduce local recurrence in extremity giant cell tumor of bone: a case-control study. Bone. 2007;42:68-73.
Gouin F, Rochwerger AR, Di Marco A, Rosset P, Bonnevialle P, Fiorenza F, et al. Adjuvant treatment with zoledronic acid after extensive curettage for giant cell tumours of bone. Eur J Cancer. 2014;50:2425-31.
Yu X, Xu M, Xu S, Su Q. Clinical outcomes of giant cell tumor of bone treated with bone cement filling and internal fixation, and oral bisphosphonates. Oncol Lett. 2013;5:447-51.
Kundu ZS, Sen R, Dhiman A, Sharma P, Siwach R, Rana P. Effect of intravenous Zoledronic acid on histopathology and recurrence after extended curettage in giant cell tumors of bone: A comparative prospective study. Indian J Orthop. 2018;52(1):45-50.
Nishisho T, Hanaoka N, Miyagi R, Sakai T, Toki S, Takahashi M et al. Local administration of zoledronic acid for giant cell tumor of bone. Orthopedics. 2015;38(1):25-30.
Cheng YY, Huang L, Lee KM, Xu JK, Zheng MH, Kumta SM. Bisphosphonates induce apoptosis of stromal tumour cells in giant cell tumour of Bone. Calcif Tissue Int. 2004;75:71-7.
Gaston CL, Grimer RJ, Parry M, Stacchiotti S, Dei Tos AP, Gelderblom H et al. Current status and unanswered questions on the use of Denosumab in giant cell tumor of bone. Clin Sarcoma Res. 2016;6(1):15.
Chawla S, Henshaw R, Seeger L, Choy E, Blay JY, Ferrari S et al. Safety and efficacy of Denosumab for adults and skeletally mature adolescents with giant cell tumor of bone: interim analysis of open-label parallel-group, phase 2 study. Lancet Oncol. 2013;14(9):901-8.
Saibaba B, Chouhan DK, Kumar V, Dhillon MS, Rajoli SR. Curettage and reconstruction by the sandwich technique for giant cell tumours around the knee. J Orthop Surg. 2014;22:351-5.
Gao ZH, Yin JQ, Xie XB, Zou CY, Huang G, Wang J, et al. Local control of giant cell tumors of the long bone after aggressive curettage with and without bone cement. BMC Musculoskeletal Disord. 2014;15:330.