Giant cell tumor of the extremity: A review of 349 cases from a single institution

Errani, Costantino; Ruggieri, Pietro; Asenzio, Marco Antonio Nogales; Toscano, Angelo; Colangeli, Simone; Rimondi, Eugenio; Rossi, Giuseppe; Longhi, Alessandra; Mercuri, Mario

doi:10.1016/j.ctrv.2009.09.002

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Volume 36, Issue 1 , Pages 1-7, February 2010

Giant cell tumor of the extremity: A review of 349 cases from a single institution

Costantino Errani
- Musculoskeletal Oncology Department, Istituto Ortopedico Rizzoli, via Pupilli n1, 40136 Bologna, Italy
- Corresponding author. Tel.: +39 051 6366222; fax: +39 051 331710.
Pietro Ruggieri
- Musculoskeletal Oncology Department, Istituto Ortopedico Rizzoli, via Pupilli n1, 40136 Bologna, Italy
- Tel.: +39 051 6366460; fax: +39 051 331710.
Marco Antonio Nogales Asenzio
- Servicio de Cirugia Ortopedica y Traumatología, Hospital Universitario Infanta Cristina, Badajoz, Spain
- Tel.: +39 051 6366222; fax: +39 051 331710.
Angelo Toscano
- Musculoskeletal Oncology Department, Istituto Ortopedico Rizzoli, via Pupilli n1, 40136 Bologna, Italy
- Tel.: +39 051 6366222; fax: +39 051 331710.
Simone Colangeli
- Musculoskeletal Oncology Department, Istituto Ortopedico Rizzoli, via Pupilli n1, 40136 Bologna, Italy
- Tel.: +39 051 6366222; fax: +39 051 331710.
Eugenio Rimondi
- Musculoskeletal Oncology Department, Istituto Ortopedico Rizzoli, via Pupilli n1, 40136 Bologna, Italy
- Tel.: +39 051 6366376; fax: +39 051 6366280.
Giuseppe Rossi
- Musculoskeletal Oncology Department, Istituto Ortopedico Rizzoli, via Pupilli n1, 40136 Bologna, Italy
- Tel.: +39 051 6366028; fax: +39 051 6366280.
Alessandra Longhi
- Musculoskeletal Oncology Department, Istituto Ortopedico Rizzoli, via Pupilli n1, 40136 Bologna, Italy
- Tel.: +39 051 6366374; fax: +39 051 6366277.
Mario Mercuri
- Musculoskeletal Oncology Department, Istituto Ortopedico Rizzoli, via Pupilli n1, 40136 Bologna, Italy
- Tel.: +39 051 6366222; fax: +39 051 331710.

Received 22 May 2009; received in revised form 18 September 2009; accepted 25 September 2009. published online 02 November 2009.

Summary

Giant cell tumor is still one of the most controversial and discussed bone tumors. Surgical treatment options include intralesional excision or segmental resection. Curettage has a higher recurrence rate but does preserve adjacent joint function. After curettage, the use of adjuvant therapies is still controversial. Three hundred forty-nine patients with giant cell tumors of the extremity, treated in a single institution, were analyzed in a retrospective study. Two hundred patients underwent curettage of the lesion and in 64 of these cases, three local adjuvants, such as phenol, alcohol and cement, were employed. The hypothesis is that an “aggressive curettage” with phenol, alcohol and cement provides better local control and functional results. The correlation between tumor in the proximal femur and higher recurrence rate has not been recorded before. The results of the present study suggest that an “aggressive curettage” reduces the recurrence rate in a disease whose aggressiveness is not easy to predict. Special attention must be given to giant cell tumors not only in the distal radius, but also in the proximal femur, where the treatment is more difficult and associated with a higher rate of local recurrence.

Keywords: Bone tumor, Giant cell tumor, Extremity, Surgery, Curettage, Resection