Skip to main content

Advertisement

SpringerLink
Log in

Clinical and Radiological Profile of Ten Interesting Though Rare Presentations of Giant Cell Tumor of Bone

  • Original Article
  • Published:
Indian Journal of Surgical Oncology Aims and scope Submit manuscript

Abstract

Giant cell tumor (GCT) is a benign but locally aggressive lesion of the bone. They are common in skeletally matured individuals with female preponderance. Unusual presentations can occur rarely. This study aims to find out the clinical and radiological profile of ten rare presentations of GCT. We have conducted a retrospective analysis of medical records of ten interesting presentations of giant cell tumor of bone. There was a patient with soft-tissue recurrence after excision. In five cases, the GCT occurred at rare sites and a case to discuss the radiological dilemma in the diagnosis. One case of pathological fracture, another case of seeding of tumor cells in the graft donor site, and a case of pulmonary metastasis were included. There were seven females, two males, and a boy. Out of ten patients, all except two cases were primarily treated at our institution. Clinical profiles of soft-tissue recurrence, rare sites of occurrence, diagnostic dilemma, pathological fracture, seeding at donor site, and metastasis were analyzed and presented. GCT, even though it is a benign lesion, can have a variety of clinical presentations and complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10

Similar content being viewed by others

References

  1. Chakarun CJ, Forrester DM, Gottsegen CJ et al (2013) Giant cell tumor of bone: review, mimics, and new developments in treatment. RadioGraphics 33(1):197–211. Retrieved June 25, 2019, from. https://doi.org/10.1148/rg.331125089

    Article  PubMed  Google Scholar 

  2. Turcotte RE (2006) Giant cell tumor of bone. Orthop Clin N Am 37(1):35–51. Retrieved June 25, 2019, from. https://doi.org/10.1016/j.ocl.2005.08.005

    Article  Google Scholar 

  3. Anshul Sobti DNB, Pranshu Agrawal MS, Sanjay Agarwala MS et al (2016) Giant cell tumor of bone—an overview. Arch Bone Jointt Surg 4(1):2–9 PMCID: PMC4733230PMID: 26894211

    Google Scholar 

  4. Turcotte RE, Wunder JS, Isler MH et al (2002) Giant cell tumor of long bone: a Canadian Sarcoma Group Study. Clin Orthop Relat Res 397:248–258. Retrieved June 24, 2019, from. https://doi.org/10.1097/00003086-200204000-00029

    Article  Google Scholar 

  5. Hoch B, Hermann G, Klein MJ, Abdelwahab IF et al (2007) Giant cell tumor complicating Paget disease of long bone. Skelet Radiol 36(10):973–978. Retrieved June 24, 2019, from. https://doi.org/10.1007/s00256-007-0310-x

    Article  Google Scholar 

  6. Hoch B, Hermann G, Klein MJ, Abdelwahab IF, Springfield D. Giant cell tumor complicating Paget disease of long bone. Skeletal Radiol [Internet]. 2007Jan.1 [cited 2019Jun.24];36(10):973–8. from: https://doi.org/10.1007/s00256-007-0310-x

  7. Bertoni F, Bacchini P, Staals EL (2003) Malignancy in giant cell tumor of bone. Cancer 97(10):2520–2529. Retrieved June 25, 2019, from. https://doi.org/10.1002/cncr.11359

    Article  PubMed  Google Scholar 

  8. Okamoto Y, Mathew S, Daw NC, Neel MD et al (2003) Giant cell tumor of bone with pulmonary metastases. Med Pediatr Oncol 41(5):454–459. Retrieved June 25, 2019, from. https://doi.org/10.1002/mpo.10258

    Article  PubMed  Google Scholar 

  9. Cavanna L, Biasini C, Monfredo et al (2014) Giant cell tumor of bone. Oncologist 19(11):1207. Retrieved June 25, 2019, from. https://doi.org/10.1634/theoncologist.2014-0267

    Article  PubMed  PubMed Central  Google Scholar 

  10. Tornberg D, Dick H, Johnston A (1975) Multicentric giant-cell tumors in the long bones. A case report. J Bone Joint Surg 57(3):420–422 Retrieved June 30, 2019, from. https://doi.org/10.2106/00004623-197557030-00026

    Article  CAS  PubMed  Google Scholar 

  11. Arnold RT, van Holsbeeck MT, Mayer TG et al (2011) Best cases from the AFIP: necrotic giant cell tumor of bone manifesting with pathologic fracture. RadioGraphics 31(1):93–98. Retrieved June 30, 2019, from. https://doi.org/10.1148/rg.311105048

    Article  PubMed  Google Scholar 

  12. Natarajan MV, Shantha V, Krishnamurthi S (1992) Limb salvage by custom prosthesis. Madras Exp:173–178. Retrieved July 1, 2019, from. https://doi.org/10.1007/978-4-431-68364-3_20

  13. Erler K, Demiralp B, TanerOzdemir M et al (2004) Treatment of proximal fibular tumors with en bloc resection. Knee 11(6):489–496. Retrieved June 30, 2019, from. https://doi.org/10.1016/j.knee.2003.10.005

    Article  PubMed  Google Scholar 

  14. McDonald DJ, Sim FH, Mcleod RA et al (1986) Giant-cell tumor of bone. J Bone Joint Surg 68(2):235–242. Retrieved June 30, 2019, from. https://doi.org/10.2106/00004623-198668020-00009

    Article  CAS  PubMed  Google Scholar 

  15. Labs K, Perka C, Schmidt RG (2001) Treatment of stages 2 and 3 giant-cell tumor. Arch Orthop Trauma Surg 121(1–2):83–86. Retrieved June 30, 2019, from. https://doi.org/10.1007/s004020000158

    Article  CAS  PubMed  Google Scholar 

  16. Trieb K, Bitzan P, Lang S, Dominkus M et al (2001) Recurrence of curetted and bone-grafted giant-cell tumors with and without adjuvant phenol therapy. Eur J Surg Oncol (EJSO) 27(2):200–202. Retrieved June 30, 2019, from. https://doi.org/10.1053/ejso.2000.1086

    Article  CAS  Google Scholar 

  17. Kivioja AH, Blomqvist C, Hietaniemi K et al (2008) Cement is recommended in intralesional surgery of giant cell tumors: a Scandinavian Sarcoma Group study of 294 patients followed for a median time of 5 years. Acta Orthop 79(1):86–93. Retrieved June 30, 2019, from. https://doi.org/10.1080/17453670710014815

    Article  PubMed  Google Scholar 

  18. Xu L, Jin J, Hu A, Xiong J, Wang D et al (2017) Soft tissue recurrence of giant cell tumor of the bone: prevalence and radiographic features. J Bone Oncol 9:10–14. Retrieved June 30, 2019, from. https://doi.org/10.1016/j.jbo.2017.09.002

    Article  PubMed  PubMed Central  Google Scholar 

  19. Gotecha D, Bhalerao N, Gadre N, Pote U (n.d.) Giant cell tumor of the calcaneus: a case report. Ijss. Retrieved July 1, 2019, from. https://doi.org/10.17354/sur/2015

  20. Varshney A, Rao H, Sadh R (2010) Multicentric GCT of tarsal bones in an immature skeleton: a case report with review of literature. J Foot Ankle Surg 49(4):399.e1–399.e4. Retrieved July 1, 2019, from. https://doi.org/10.1053/j.jfas.2010.04.010

    Article  Google Scholar 

  21. Mechlin MB, Kricun ME, Stead J et al (1984) Giant cell tumor of tarsal bones. Skelet Radiol 11(4):266–270. Retrieved July 1, 2019, from. https://doi.org/10.1007/bf00351351

    Article  CAS  Google Scholar 

  22. Rajani R, Schaefer L, Scarborough MT, Gibbs CP (2015) Giant cell tumors of the foot and ankle bones: high recurrence rates after surgical treatment. J Foot Ankle Surg 54(6):1141–1145. Retrieved July 2, 2019, from. https://doi.org/10.1053/j.jfas.2014.08.016

    Article  PubMed  Google Scholar 

  23. Ahn JH, Choy WS, Kim HY (2011) Midfoot reconstruction for a large, aggressive giant-cell tumor. J Bone Joint Surg Am 93(22):e133(1)–e133(6). Retrieved July 2, 2019, from. https://doi.org/10.2106/jbjs.j.01676

    Article  Google Scholar 

  24. Lichtinger TK, Heimkes B (2004) Reconstruction of the greater trochanter with an allograft after resection of a giant cell tumor. Arch Orthop Trauma Surg 124(10):715–717

    Article  Google Scholar 

  25. Kinyanjui JW (2018) Giant cell tumor of greater trochanter apophysis: case report. East Afr Orthop J 12(1):42–44

    Google Scholar 

  26. Adulkasem N, Pruksakorn D (2019) Giant cell tumor of the middle phalanx of the middle finger. BMJ Case Rep CP 12(3):e229076

    Article  Google Scholar 

  27. Afshar A, Tabrizi A, Aidenlou A, Abbasi A (2018) Giant cell tumor of the capitate bone. J Hand Microsurg 10(03):158–161. Retrieved July 2, 2019, from. https://doi.org/10.1055/s-0038-1631876

    Article  PubMed  PubMed Central  Google Scholar 

  28. Maini L, Cheema GS, Yuvarajan P, Gautam VK (2011) Free osteoarticular metatarsal transfer for giant cell tumor of metacarpal—a surgical technique. J Hand Microsurg 3(02):89–92

    Article  Google Scholar 

  29. Saguem I, Ayadi L, Kallel R, Charfi S, Bahri I, Gouiaa N, Sellami-Boudawara T (2016) Telangiectatic osteosarcoma of the rib: a rare entity and a potential diagnostic pitfall. Pathologica. 108(4):175–178

    CAS  PubMed  Google Scholar 

  30. Wijsbek AE, Vazquez-Garcia BL, Grimer RJ et al (2014) Giant cell tumour of the proximal femur. Bone Joint J 96-B(1):127–131. Retrieved July 2, 2019, from. https://doi.org/10.1302/0301-620x.96b1.31763

    Article  CAS  PubMed  Google Scholar 

  31. Carvallo PI, Griffin AM, Ferguson PC, Wunder JS (2015) Salvage of the proximal femur following pathological fractures involving benign bone tumors. J Surg Oncol 112(8):846–852

    Article  Google Scholar 

  32. Kundu ZS, Gupta V, Sangwan SS, Goel S, Rana P (2013) Iatrogenic giant cell tumor at bone graft harvesting site. Indian J Orthop 47(1):107–110

    Article  Google Scholar 

  33. Cunha-Gomes D, Bhathena HM, Kavarana NM (2001) The anterolateral thigh flap: a versatile pedicled and free flap transfer. Eur J Plast Surg 24(2):80–84

    Article  Google Scholar 

  34. Viswanathan S, Jambhekar NA (2010) Metastatic giant cell tumor of bone: are there associated factors and best treatment modalities? Clin Orthop Relat Res 468(3):827–833

    Article  Google Scholar 

  35. Sanjay BKS, Kadhi SM (1998) Giant cell tumor of bone with pulmonary metastases. Int Orthop 22(3):200–204. Retrieved July 2, 2019, from. https://doi.org/10.1007/s002640050242

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Gupta R, Seethalakshmi V, Jambhekar NA, Prabhudesai S, Merchant N, Puri A, Agarwal M (2008) Clinicopathologic profile of 470 giant cell tumors of bone from a cancer hospital in western India. Ann Diagn Pathol 12(4):239–248

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedics, Government Medical College, Kozhikkode, Kerala, PIN-673008, India

    Balaji Zacharia & Puneeth Katapadi Pai

  2. Department of Surgical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India

    Manu Paul

Authors
  1. Balaji Zacharia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Puneeth Katapadi Pai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Manu Paul
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors helped in data collection, analysis, writing, and editing the manuscript.

Corresponding author

Correspondence to Balaji Zacharia.

Ethics declarations

Conflict of Interest

We have no conflict of interest for this manuscript and we have not accepted any financial assistance from within or outside of our institution for collecting data, writing the manuscript, and for its publications.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zacharia, B., Pai, P.K. & Paul, M. Clinical and Radiological Profile of Ten Interesting Though Rare Presentations of Giant Cell Tumor of Bone. Indian J Surg Oncol 11, 527–537 (2020). https://doi.org/10.1007/s13193-020-01134-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13193-020-01134-2

Keywords

Search

Navigation