Indexed on: 18 Dec '03Published on: 18 Dec '03Published in: Zeitschrift fur Orthopadie und ihre Grenzgebiete
Giant cell tumor (GCT) of bone is a very peculiar and interesting tumor due to of its biological behavior and the phenomenon of pulmonary metastases of a histologically benign tumor. We present the results of a retrospective study.Between 1965 and 2002 we treated 87 patients, 54 women and 33 men, for a GCT of bone. The average age of the patients was 28.2 (range 8-72) years. The median follow-up time was 91 months. 63 patients (72.4%) were hospitalized with a primary tumor. Twelve of these patients (19 %) had a pathological fracture. 24 patients (27.6%) presented with local recurrence. 7 tumors were malignant GCT of bone, 80 tumors were benign. According to the classification of Campanacci, 9 patients (10.3%) were diagnosed in stage I, 42 (48.3%) in stage II, and 36 (41.4%) in stage III. Surgical procedures were intralesional curettage and packing with cement in 36 patients, and bone-grafting in 7. In 35 cases we performed a wide resection, and in nine an amputation.Local recurrence was observed in 11 patients (12.6%), all of them were benign GCT. Local recurrences were followed by an intralesional curettage and bone-grafting in three cases (42.8%), packing with cement in seven (19.4%). Three patients with local recurrence (27.3%) also had synchronous pulmonary metastases. All patients diagnosed with benign GCT are still alive. 3 out of 7 patients with malignant GCT died from progression of metastatic disease.To reduce the risk of local recurrence and pulmonary metastases, we recommend an adjuvant therapy of GCT.