Abstract
Giant cell tumor (GCT) of bone is a locally aggressive benign neoplasm that is associated with a large biological spectrum ranging from latent benign to highly recurrent and occasionally metastatic malignant bone tumor. It accounts for 4–10% of all bone tumors and typically affects the meta-epiphyseal region of long bones of young adults. The most common site involved is the distal femur, followed by the distal radius, sacrum, and proximal humerus. Clinical symptoms are nonspecific and may include local pain, swelling, and limited range of motion of the adjacent joint. Radiographs and contrast-enhanced magnetic resonance imaging (MRI) are the imaging modalities of choice for diagnosis. Surgical treatment with curettage is the optimal treatment for local tumor control. A favorable clinical outcome is expected when the tumor is excised to tumor-free margins, however, for periarticular lesions this is usually accompanied with a suboptimal functional outcome. Local adjuvants have been used for improved curettage, in addition to systematic agents such as denosumab, bisphosphonates, or interferon alpha. This article aims to discuss the clinicopathological features, diagnosis, and treatments for GCT of bone.
Highlights
Giant cell tumor (GCT) of bone is a relatively common, locally aggressive benign neoplasm that is associated with a large biological spectrum ranging from latent benign to highly recurrent and occasionally metastatic malignant potential [1]
It has been suggested that the GCT should be preferably classified as per Campanacci et al [3] as this classification scheme may more guide treatment; grade 1 and grade 2 lesions should be treated with intralesional curettage, and grade 3 lesions with en block resection and reconstruction, if necessary [20]
In spite of the positive results and low recurrence rates, the high fracture risk due to difficult control of the depth of the induced osteonecrosis prevents this procedure from becoming the method of choice [92]; polymethyl methacrylate (PMMA) cementation still remains the preference for filling the defect of curettage and as local adjuvant
Summary
Abstract – Giant cell tumor (GCT) of bone is a locally aggressive benign neoplasm that is associated with a large biological spectrum ranging from latent benign to highly recurrent and occasionally metastatic malignant bone tumor. It accounts for 4–10% of all bone tumors and typically affects the meta-epiphyseal region of long bones of young adults. Clinical symptoms are nonspecific and may include local pain, swelling, and limited range of motion of the adjacent joint. Local adjuvants have been used for improved curettage, in addition to systematic agents such as denosumab, bisphosphonates, or interferon alpha.
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