Slide 2 of 23
Notes:
Giant cell tumor (GCT) of the bone is a benign, but locally aggressive and destructive lesion. It is composed of primitive histiocytes and diffuse, large, multinucleated giant cells. It is common - 20% benign tumors of bone.
Young adults - uncommon in children (ɮ% open epiphyses)
The most common sites include the distal femur, proximal tibia, and distal radius.
GCT typically involves the epiphysiometaphyseal region of long bones. The tumor almost always extends up to the adjacent articular cartilage.
Histologically the lesion is composed of osteoclast-like multinucleated giant cells in a moderately vascularized network of proliferating round, oval or spindle shaped stromal cells. Ossification and osteoid production are noted in small foci at the periphery of the lesions, particularly in soft tissue extensions
Giant cell tumors are prone to local recurrence. Although benign, in 3.5% of patients they shows metastases to the lungs.
Treatment: The treatment of GCT is directed towards local control without sacrificing joint function. This has traditionally been achieved by intralesional curettage with autograft reconstruction by packing the cavity of the excised tumor with morselised iliac cortico-cancellous bone- up to 60% recurrence with this method.