Article

Giant cell tumor of bone in the foot and ankle.

Orthopaedic Oncology Unit, Massachusetts General Hospital, Boston, USA.
Foot & Ankle International (Impact Factor: 1.63). 11/1995; 16(10):617-23. DOI: 10.1177/107110079501601007
Source: PubMed

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.

0 Followers
 · 
114 Views
  • [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: Detection of recurrence of tumors with conventional imaging like computed tomography (CT) and magnetic resonance imaging (MRI) can be difficult because of distorted anatomy and implants in situ. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT has been shown to be very useful in detection of recurrent tumors with higher accuracy than conventional imaging method. Giant cell tumors of foot though rare have high recurrence potential after initial curative treatment. However, currently there is no literature addressing the role of F-18 FDG PET/CT in evaluation of these tumors. We report a case of post excisional recurrent giant cell tumor of foot diagnosed on F-18 FDG PET/CT. In addition, to detection of recurrence F-18 FDG PET/CT also aided in accurate management of the patient.
    10/2012; 27(4):262-3. DOI:10.4103/0972-3919.115402
  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: The distal tibia is an unusual location for a giant cell tumor (GCT). Treatment choices are unclear because of their rarity, the anatomy of the ankle, and difficulties associated with reconstruction. QUESTIONS/PURPOSES: We assessed: (1) the treatment modalities used by participating Canadian bone tumor centers for distal tibia GCTs; (2) the incidence of local recurrence and their management; and (3) patients' function after treatment. METHODS: A prospective tumor database served to identify all 31 patients with primarily treated distal tibia GCTs between 1991 and 2010. We extracted patients and tumor characteristics, treatment modalities for initial and recurrent tumors, and the Musculoskeletal Tumor Society (MSTS) and Toronto Extremity Salvage (TESS) scores. The median followup was 58 months (range, 24-192 months). RESULTS: Extended curettage was the only modality of treatment for all patients including all subsequent local recurrences. Nine had local recurrence, three of which had a second local recurrence; one had a third recurrence. Ultimately all patients were in remission at last followup. The local recurrence rate was 29% and appeared higher compared with recent series of all anatomic sites. The mean final MSTS and TESS scores were 91% (range, 71%-100%) and 88% (range, 35%-100%), respectively. CONCLUSIONS: Extended curettage was the unique modality of surgical treatment for all tumors. We found the incidence of local recurrence higher than that reported for other locations but recurrences were manageable with repeated curettage. Complications and function appeared better than those reported for series of ankle fusion or reconstruction for bone tumors. LEVEL OF EVIDENCE: Level IV, retrospective study. See Guidelines for Authors for a complete description of levels of evidence.
    Clinical Orthopaedics and Related Research 04/2013; 471(8). DOI:10.1007/s11999-013-2965-z · 2.88 Impact Factor