SLIDE 1 DI DISTAL AL RADIUS DIUS GI GIANT ANT CEL ELL TUMOR MOR TREA EATED TED WITH H EX EXCISION SION AND D REC ECONS ONSTR TRUCTION UCTION WI WITH FI FIBULAR BULAR AUTOGRAFT OGRAFT
bhansh shu u Gupta Junior
dent Dept ept of Orthopa
edics ics
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PRESENTATION
A 65/F complaints of right wrist pain and swelling since
2 yrs.
Patient was symptomatic since 2yrs with insidious onset
pain, which was mild, dull aching, persistent and associated with gradually progressive swelling over the same area.
SLIDE 3 ON ON EX EXAMINA MINATIO TION N OF OF WR WRIST
Swelling
distal 3rd of right forearm with localized tenderness, bony hard consistency .
SLIDE 4 IN INVES ESTIG TIGATION TION
X RAY
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COM OMPUTED PUTED TOM OMOGRA OGRAPHY PHY
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MRI
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Multinucleated Giant
cell in the stroma of mononuclear stromal cell.
SLIDE 11 Biopsy psy S/O /O Giant nt cell Tum umor
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TREATMENT:
Patient planned for wide excision of the tumor
and reconstruction with ipsilateral proximal end fibula autograft.
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IN INTRA RA OP OP
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PO POST T OP OP X R X RAY
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PO POST T OP P 6M 6MONTHS NTHS FOLL LLOWUP WUP
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GCT- An Overview
Distinct neoplasm arising from non bone forming
supporting connective tissue of marrow.
Epiphyseal region (metaphyseal in immature skeleton) 20-40yrs age group. F>M ( 1.5:1 ) 5% of primary and 20% of benign bone tumor. Solitary ,benign lesion which is locally aggressive Distal femur>proximal tibia>distal radius
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SLIDE 24 DISCUSSION
High rate of local recurrence. They should be treated more aggressively. Grade III lesions can be treated with curettage and grafting when
the tumor does not invade the wrist, destroy less than 50% of the cortex.
Though Functional outcome is better with curettage and bone
grafting but risk of local recurrence is high as compared with excision and grafting.
