ISSN: 2161-0533
+44-77-2385-9429
Ahmad Shaheen
University Hospital Menofia, Egypt
Posters & Accepted Abstracts: Orthop Muscular Syst
Background & Purpose: Giant Cell Tumors (GCTs) of bone are common benign bone tumors. We report 38 cases that have been treated at our institution during the last 20 years. Methods: 38 patients with histologically benign GCT were included in this study. Nine tumors were primarily located in distal radius, 6 in proximal tibia and 15 in distal femur, 5 in proximal humerous, 2 distal tibia and one proximal fibula. 28 patients were treated by extended intralesional curettage and phenol cauterization followed by bone graft impaction (24 cases) or bone substitute (4 cases). 12 patients were treated by wide resection. Wide resection was done when the lesion extended to articular cartilage or the surrounding cortex destruction was more than 50%. The patients were followed for a median time of 3 (1-11) years. Results: 28 patients had good functional and oncological outcome at final evaluation. While 12 patients had complications (31%), 7 patients had local recurrence (3 patients with a distal radius tumor and 2 patients with distal femur tumor and 2 patients with proximal tibia developed a local recurrence). Four patients had bony recurrence and 3 had soft tissue recurrence. All local recurrences occurred after intralesional curettage. Local recurrence occurred 6 months to 7 years after intralesional curettage. Soft tissue recurrence was treated by resection while curettage was done for bony recurrence after biopsy. Local recurrence in one case proved to be malignant GCT. One patient developed pulmonary metastases. Failure of reconstruction after wide resection occurred in 3 patients. Two patients had infection after bone substitute. Interpretation: We conclude that extended intralesional curettage with phenol cauterization is suitable for most of GCT with preservation of good function. Wide resection and reconstruction was done for tumors extended to articular cartilage, or with destruction of more than 50% of the surrounding cortex, functional impairment and mechanical failure is common. We advised biopsy for local recurrent GCT.
Email: Profashahin@hotmail.com