Case of giant cell tumour of proximal tibia treated with intra-lesion curettage with adjuvant therapy and reconstruction with the sandwich technique fixation
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20223465Keywords:
GCT, Sandwich technique, Curettage, Bone cement, Autologous bone graftAbstract
Giant cell tumour (GCT) of bone is a benign but locally aggressive tumour with the potential of malignant transformation that mostly involves the meta-epiphyseal region of long bones. A 34-year-old female was presented to our institute with progressive pain and swelling in her right knee and was radiologically and histologically found to have a GCT of proximal tibia. She was treated with extended curettage with power burr, intra-lesion phenol application and internal fixation using the sandwich technique. No recurrence was found and the procedure led to a good functional outcome. A GCT of proximal tibia treated with joint preserving surgery with extended curettage and the sandwich technique fixation gives optimal results leading to a good functional outcome.
References
Jaffe HL, Lichtenstein L, Portis RB. Giant cell tumor of bone. Its pathologic appearance, grading, supposed variants and treatment. Arch Pathol. 1940;30:993-1031.
Campanacci M. Giant Cell Tumor. In Gaggi A (ed). Bone and Soft-Tissue Tumors. Bologna, Springer-Verlag. 1990;117-53.
Unni KK. Dahlin’s Bone Tumors: General Aspect and Data on 11087 Cases, Ed 5. Philadelphia, Lip- pincott-Raven. 1998.
Dreinhofer KE, Rydholm A, Bauer HC. Giant cell tumours with fracture at diagnosis. Curettage and acrylic cementing in 10 cases. J Bone Joint Surg Br. 1995;77(2):189-93.
Miller G, Bettelli G, Fabbri N. Curettage of giant cell tumor of bone: introduction, material and method. Chir Organi Mov. 1990;75(1):203-4.
Campanacci M, Baldini N, Boriani S, Sudanese A. Giant-cell tumor of bone. J Bone Joint Surg (Am). 1987;69:106-14.
Ruggieri P, Mavrogenis AF, Ussia G, Angelini A, Papagelopoulos PJ, Mercuri M. Recurrence after and complications associated with adjuvant treatments for sacral giant cell tumor. Clin Orthop Relat Res. 2010;468(11):2954-61.
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 tumour of bone: interim analysis of an open-label, parallel-group, phase 2 study. Lancet Oncol. 2013;14(9):901-8.
Schajowicz F. Giant-cell tumor (osteoclastoma). In: Tumors and tumorlike lesions of bone. Berlin, Heidelberg, New York: Springer-Verlag. 1994;257-99.
Carrasco CH, Murray JA. Giant cell tumors. Orthop Clin North Am. 1989;20:395-405.
Dürr HR, Maier M, Jansson V, Baur A, Refior HJ. Phenol as an adjuvant for local control in the treatment of giant cell tumour of the bone. Eur J Surg Oncol. 1999;25:610-8.
Lack W, Lang S, Brand G. Necrotizing effect of phenol on normal tissues and on tumors. A study on postoperative and cadaver specimens. Acta Orthop Scand. 1994;65:351-4.
Dürr HR, Maier M, Jansson V, Baur A, Refior HJ. Phenol as an adjuvant for local control in the treatment of giant cell tumour of the bone. Eur J Surg Oncol. 1999;25(6):610-8.
Pan KL, Chan WH. Curettage and cementation in giant cell tumour of the distal tibia using polypropylene mesh for containment: a case report. Malays Orthop J. 2010;4:51-3.
Chen TH, Su YP, Chen WM. Giant cell tumors of the knee: subchondral bone integrity affects the outcome. Int Orthop .2005;29:30-4.
Turcotte RE, Wunder JS, Isler MH, Bell RS, Schachar N, Masri BA et al. Giant cell tumor of long bone: a Canadian Sarcoma Group study. Clin Orthop Relat Res. 2002;397:248-58.
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. 2008;42:68-73.
Chang SS, Suratwala SJ, Jung KM, Doppelt JD, Zhang HZ, Blaine TA et al. Bisphosphonates may reduce recurrence in giant cell tumor by inducing apoptosis. Clin Orthop Relat Res. 2004;426:103-9.
Neville-Webbe HL, Holen I, Coleman RE. The anti-tumour activity of bisphosphonates. Cancer Treat Rev. 2002;28:305-19.