Giant Cell Tumour of the Distal Ulna: A Rare Presentation

Ruben Jaya Kumar,Dinesh Ernest,Vijayachandran V,Thirumal Manickam

doi:10.5704/moj.1107.011

Abstract

Giant-cell tumour (GCT) of bone, a primary yet locally aggressive benign tumour, commonly affects patients between the ages of 20 and 40 years, with the peak incidence occurring in the third decade. Women are affected slightly more than men. The distal end of the ulna is an extremely uncommon site for primary bone tumours in general and giant cell tumours in particular. Wide resection of the distal ulna is the recommended treatment for GCT in such locations. Radio-ulna convergence and dorsal displacement of the ulna stump are known complications following ulna resection proximal to the insertion of the pronator quadratus. This leads to reduction in grip power and forearm rotatory motion. Stabilization of the ulna stump with extensor carpi ulnaris (ECU) tendon after wide resection of the tumour has been described in the literature. We report a case of GCT of distal end of ulna treated with wide resection and stabilization with ECU tendon.

Highlights

Giant-cell tumour (GCT) of the bone is a rare, benign but locally aggressive tumour, accounting for 3% to 5% of all primary bone tumours with less than 3% located at the distal ulna 1
We report here the case of a patient with GCT of the distal end of the ulna, treated with en-bloc resection of the distal ulna followed by stabilization of the ulna stump using the extensor carpi ulnaris (ECU) tendon
The incidence of GCT of bone is higher in Asian populations compared to the West 2

Summary

INTRODUCTION

Giant-cell tumour (GCT) of the bone is a rare, benign but locally aggressive tumour, accounting for 3% to 5% of all primary bone tumours with less than 3% located at the distal ulna 1. Treatment typically ranges from curettage alone to curettage with adjuvant therapy, wide resection or amputation 2. The goals of treatment are adequate removal of the tumour to lower the risk of recurrence and achievement of good functional outcome. We report here the case of a patient with GCT of the distal end of the ulna, treated with en-bloc resection of the distal ulna followed by stabilization of the ulna stump using the extensor carpi ulnaris (ECU) tendon

CASE REPORT

Findings

DISCUSSION