Diagnosis of giant cell reparative granuloma of the bones of the hands and feet

Abstract

Clinical, roentgenologic and morphologic features of giant cell reparative granuloma in wrist and foot bones are presented. Analysis of 2 cases and literature review shows that giant cell reparative granuloma is a rare benign fibrous osseous proliferative process of unknown etiology. No clinical symptoms and roentgenologic signs have specifical features and do not differ a lot from chondroma, giant cell tumor of bone, aneurysmal cyst, brown tumor in hyper- parathyroidism. Correct diagnosis could be made on the base of histologic study taking into account Ca, P and alkaline phosphatase content in blood. The main histologic signs of giant cell reparative granuloma are the following: presence offibroblasts, histiocytes, multinuclear osteoclast-like cells, microbloodstrokes, microcysts, osseous bridges of different maturity degree and not numerous mitoses in connective tissue stroma. Surgical treatment using currettage results in high local recurrence rate (mean 33 39%). The most adequate treatment is surgical intervention with observance of oncologic principles: marginal resection, electrocoagulation and auto- or alloplasty of none defects; in case of severe bone lesions - segmental resection or bone extirpation.