Use of cement for treatment of giant-cell tumors

Abstract

A case of giant-cell tumor (GCT) of the pelvis treated by curettage followed by packing the cavity with cement is reported. The results of different series published during the last years are discussed. The series comparing curettage and packing with resection and allografts show that recurrences occur mainly in the former and that their incidence is between 5 and 20%. Resections with allografts are followed in a considerable number of cases by complications due to the allograft. Other series relate to different sites, of which some are regarded as more dangerous: spine, pelvis, lower end of radius and upper end of fibula (where resection, if indicated, must include the whole of the upper tibiofibular articulation). The use of cement must be preceded by a scrupulous curettage of the cavity, with burring of the wall with a dental burr and possible tamponade with phenol. Cement is useful in three ways: a thermal effect on any tumor residues; support for the subchondral bone; contrast medium for postoperative monitoring. The technique of curettage and packing with cement seems indicated for benign tumors (stage III aggression does not indicate a malignant tumor), whose walls are not breached, including a stage of recurrence.