Summary
Thirty-one patients with giant cell tumours of bone (BGCT) were treated at our hospital by a conservative approach between 1975 and 1988. 94% of the tumours were grade III (Campanacci) and the follow up was from 2 to 13 years. In the 20 patients who had a modified intralesional excision (curettage) with bone grafting and cement, 5 recurrences occurred. There was one soft tissue recurrence in the 11 patients who had marginal or wide excisions. All recurrences were in grade III lesions. We conclude that grade III BGCT can be treated by modified intralesional excision provided the articular surfaces and part of the metaphysis are intact.
Résumé
Nombre d'auteurs recommandent de réaliser une exérèse étendue dans les tumeurs à cellules géantes (TCG) de degré 3. En raison de la manière locale habituelle de prier et de s'asseoir, nous avons tenté de conserver les articulations même chez les patients ayant des tumeurs assez avancées. De 1975 à 1988 nous avons traité 31 de ces malades à l'hôpital spécialisé King Faisal à Riyadh. L'âge moyen était de 31.4 ans. 94% des tumeurs étaient du degré III de Campanacci. Les patients ont été suivis de 2 à 13 ans. Sur les 20 malades traités par curettage et comblement au ciment, 5 ont présenté une récidive. Sur les 11 patients traités par exérèse marginale ou étendue, il y a eu une récidive dans les parties molles. Le taux global de récidive a été de 19.4%. Toutes les récidives sont survenues sur des lésions de degré III. Notre conclusion est que les TCG de degré III de Campanacci peuvent être traitées par une excision intralésionnelle modifiée avec comblement de ciment, à condition que les surfaces articulaires et une partie de la métaphyse soient intactes.
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Rooney, R.J., Asirvatham, R., Lifeso, R.M. et al. Giant cell tumour of bone. International Orthopaedics 17, 87–92 (1993). https://doi.org/10.1007/BF00183548
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DOI: https://doi.org/10.1007/BF00183548