Giant Cell Tumour এর ময়নাতদন্ত

Giant cell tumour:

Definition: It is an osteolytic of uncertain origin appears mostly in epiphysis in the long bone.

Other names:

1. Osteoclastoma
2. Giant cell sarcoma
3. Benign giant cell tumor

Because of it’s rarely metastatic character giant cell tumor is a locally malignant tumor because rarely metastasis.

Age of onset: 20-45 years (most common in female, usually 3rd decades of life).

Site of onset: Around knee, proximal humerus, distal radius (most common).

History of trauma present (may be)

Chief complaint:

1.Pain

2. Swelling –

Towards one side
Skin over the lesion is shiny
Egg shell cracking sound may be on applying pressure.

At the beginning there’s no changes in joint movement but later joint movement diminished.

Investigation:

1. X-ray
2. CT scan
3. MRI (Magnetic resonance imaging)
4. Arthroscopy

Biochemical test:

1. Serum Calcium
2. Serum phosphate
3. Serum alkaline phosphatase
4. Routine blood test

X-ray findings :

1. Round/oval osteolytic lesion (epiphyseal, eccentric, expanded size).
2. The cortex is thin & ballooned.

Treatment :

Generally treatment depends on size of tissue bone involvement, staging & grading.

1. Curettage only (85% recurrent)
2. Bone curettage with bone graft (40%).
3. Chemical cauterization + curettage
4. Curettage + cauterization + bone graft
5. Curettage + chemical cauterization + Bone Cement
6. Curettage + cryosurgery with liquid nitrogen + bone graft.
7. Margin excision + bone graft (36%)
8. Wide excision + bone graft
9. Amputation

If pulmonary metastasis occur-

1. Embolization
2. Excision

Sazzad mahmud

Monowara Sikder Medical College (2015-16).

Platform Academic / Gazi Abdullah Al Mamun