Giant Cell Tumor of Bone in the Foot and Ankle

Orthopaedic Oncology Unit, Massachusetts General Hospital, Boston, USA.
Foot & Ankle International (Impact Factor: 1.51). 11/1995; 16(10):617-23. DOI: 10.1177/107110079501601007
Source: PubMed


Giant cell tumor of bone has been shown to behave more aggressively when located in the wrist and hand. Although nearly 4% of giant cell tumors arise in the foot and ankle, biological features specific to this location have not been identified. In our experience with more than 300 cases of giant cell tumor, 12 arose in the foot and ankle and were followed for more than 2 years. These included nine females and three males ranging in age from 15 to 52 years (mean age, 29.5 years). All patients presented with pain of 5.0 months' mean duration and 9 of 12 tumors demonstrated aggressive radiographic features, including bone erosion and destruction; five had either invasion of a joint or a soft tissue mass present. Unlike the hand, where metacarpal and phalangeal lesions are common, no tumors arose in the forefoot and nine of the tumors were present in the ankle region. Four patients were treated with resection (no recurrence), two with curettage and cement packing (one recurrence), and six with curettage and autologous bone graft (two recurrences), which resulted in an overall recurrence rate of 25%. None of the recurrent tumors have returned after additional treatment, which consisted of curettage and cement packing in two cases and resection in one case. Five tumors (four primary, one recurrent) were treated with local resection and reconstruction with no major complications and with no amputations performed. Thus, giant cell tumors of the foot and ankle can be treated with local procedures, which result in recurrence rates similar to those found in more common locations.

5 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We studied DNA ploidy by smear cytophotometry and proliferation activity by Ki-67 MIB immunohistochemistry in 69 primary and recurrent giant cell tumors (GCT) from 50 randomly selected patients. The obtained results were evaluated with comparisons made to the available clinical data. From the 46 primary tumors 63% showed diploidy and 37% aneuploidy. A significantly (P=0.026) higher recurrence rate (64%) was observed in aneuploid than in diploid tumors (31%). In the course of the recurrences, both the ratio of aneuploid tumors as well as the proliferation index of the tumors increased, though the degree of the latter was non-significant. Aneuploidy did not mean an unambiguous tendency towards malignant transformation; however, a close follow-up of recurrent aneuploid tumors, and wide excision of the recurrence instead of intralesional curettage are the recommended procedures. The DNA cytophotometry and proliferation index of GCTs--as compared to other histologic examinations--are of prognostic value in the evaluation of the recurrence potential of the GCTs.
    International Orthopaedics 02/1999; 23(6):315-9. DOI:10.1007/s002640050381 · 2.11 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Giant cell tumours are uncommon benign osseous neoplasia. Most occur around the epiphysis of long bones after skeletal maturity and are very rarely seen in the foot. We present a case of a fifteen-year-old amateur basketball player who presented with a painful ‘peroneal spastic foot’ that was diagnosed to be due to a giant cell tumour of the cuboid bone. There was a good response to a curettage and bone grafting, with no recurrence at his thirty-month follow-up.
    The Foot 06/2001; 11(2):94-96. DOI:10.1054/foot.2001.0679
  • [Show abstract] [Hide abstract]
    ABSTRACT: Summary According to the latest literature, the authors report epidemiological data, clinical observations, radiographic features and diagnostic findings of bone and soft tissue tumours of the foot. Observations on biopsy, principles of staging, treatment indications and data about prognosis are related to the literature.
    Foot and Ankle Surgery 08/2002; 8(3):175 - 190. DOI:10.1046/j.1460-9584.2002.00322.x
Show more