Giant cell tumor of bone in the foot and ankle.
ABSTRACT 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.
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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 · 2.02 Impact Factor
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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
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ABSTRACT: Giant cell tumor of the distal fibula is a very rare condition. The treatment of advanced tumors at this location can be challenging and has been described in the literature only in single cases. We report on a patient with a stage III giant cell tumor, according to the classification of Campanacci, of the distal fibula after en bloc resection and distal fibula reconstruction with a long bone graft from the iliac crest in a second procedure. The syndesmosis was reconstructed with a periosteal flap, the capsule and ligaments with local scar tissue. Fifteen years after the initial treatment the patient is free of local recurrence and demonstrates an excellent clinical outcome without any signs of instability, loss of function or osteoarthritis of the ankle joint. We suggest the method to be worthwhile for treatment of this uncommon lesion in terms of recurrence and functional outcome.Archives of Orthopaedic and Trauma Surgery 02/2004; 124(1):56-9. DOI:10.1007/s00402-003-0562-4 · 1.31 Impact Factor