Clinical and Radiological Profile of Ten Interesting Though Rare Presentations of Giant Cell Tumor of Bone
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ORIGINAL ARTICLE
Clinical and Radiological Profile of Ten Interesting Though Rare Presentations of Giant Cell Tumor of Bone Balaji Zacharia 1
&
Puneeth Katapadi Pai 1 & Manu Paul 2
Received: 22 October 2019 / Accepted: 8 June 2020 # Indian Association of Surgical Oncology 2020
Abstract Giant cell tumor (GCT) is a benign but locally aggressive lesion of the bone. They are common in skeletally matured individuals with female preponderance. Unusual presentations can occur rarely. This study aims to find out the clinical and radiological profile of ten rare presentations of GCT. We have conducted a retrospective analysis of medical records of ten interesting presentations of giant cell tumor of bone. There was a patient with soft-tissue recurrence after excision. In five cases, the GCT occurred at rare sites and a case to discuss the radiological dilemma in the diagnosis. One case of pathological fracture, another case of seeding of tumor cells in the graft donor site, and a case of pulmonary metastasis were included. There were seven females, two males, and a boy. Out of ten patients, all except two cases were primarily treated at our institution. Clinical profiles of soft-tissue recurrence, rare sites of occurrence, diagnostic dilemma, pathological fracture, seeding at donor site, and metastasis were analyzed and presented. GCT, even though it is a benign lesion, can have a variety of clinical presentations and complications. Keywords Giant cell tumor of bone . Soft-tissue recurrence in GCT . Metastasis in GCT . Seeding of tumor cells in GCT
Introduction Giant cell tumors (GCTs) of bone are benign but locally aggressive lesions. They account for 5% of all primary bone tumors and 20% of benign skeletal tumors [1]. The name “giant cell tumor” was suggested by Cooper and Traversin in 1818. Later, Virchow suggested malignant potential (1846). Nelaton (1860) found out the similarities between Osteoclasts and osteoclasts. Even though Bloodgood reported its benign nature, most of the current understanding of this tumor came from the work of Jaffe and colleagues [2]. The most common location of GCT is the epiphysis of long bones.
* Balaji Zacharia [email protected] Puneeth Katapadi Pai [email protected] Manu Paul [email protected] 1
Department of Orthopedics, Government Medical College, Kozhikkode, Kerala PIN-673008, India
2
Department of Surgical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
They are frequently seen after skeletal maturity in the third and fourth decades. Females are more commonly affected. Though benign, about 1% to 9% of cases metastasize to the lung especially locally aggressive and recurrent lesion [3]. The most common sites of involvement are the lower end of the femur, proximal tibia, and distal radius [4]. It is seen in other locations like pelvis, sacrum, and facial bones. In these rare locations, it is associated with Paget disease of bone [5]. Radiologically, it is an eccentric expansile, epiphyseal lytic lesion. It is seen in the subchondral region and ex
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