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