[Diagnosis and surgical treatment of giant cell tumor in hand bone]. 2012

Yang Guo, and Chun Li, and Guang-lei Tian, and Bao-guo Jiang, and Jun-hui Zhao, and Wen Tian, and Shan-lin Chen, and Hai-hua Wang
Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing, China.

OBJECTIVE To review the experience with clinical and imaging characteristics of giant cell tumor (GCT) of the hand as well as the surgical outcomes. METHODS Between 2000 and 2010,16 cases of GCT of the hand were admitted to our department. There were 10 male and 6 female patients with a mean age of 41.3 years (age range: 24 to 65 years) with Campanacci's grade I ( n = 0), Grade II (n=12), and Grade III (n=4). Eight cases occurred in metacarpal bone and 8 cases in phalanx. All patients had the symptoms of pain,swelling and restricted range of motion in the affected joint.The average time from the onset of the symptom to the first visit of the patients was 12 months( range: 5 to 15 months).Radiographic changes showed osteolytic lesions occupying at least half of the diaphyseal region in most of the cases. Four grade III patients underwent tumor resection and bone graft or serial amputation, while 12 Grade II patients extensive curettage and bone graft. RESULTS Twelve patients'clinical and radiographic diagnosis at admission was endochondroma, while postoperative histopathology reported all the lesions as GCT. Twelve patients were followed up for a mean of 58.8 months (range: 24 to 140 months). Immediate relief of pain was observed postoperatively in all patients. No complications, such as infection or joint stiffness, were observed in any patient. The average healing time of bone graft was 3.3 months (range: 3 to 5 months).Ten gradeII patients were followed up for at least 2 years and 3 of them had local recurrence 8 to 16 months after first resection. En bloc resection was then performed, and no second reccurence was reported. Two gradeII patients were followed up for at least 2 years and none of them had local recurrence. No malignancy, multiple center lesion or lung metastasis was reported. Active range of motion in the patients without joint arthrodesis was maintained during the follow-up period. CONCLUSIONS GCTs of the hand are relatively rare, and tend to be misdiagnosed as endochondroma. The results of the present study suggest that extensive curettage provides favorable local control and satisfactory functional outcomes.

UI MeSH Term Description Entries
D007085 Ilium The largest of three bones that make up each half of the pelvic girdle. Auricular Surface of Ilium,Iliac Crest,Iliac Crest Bone,Iliac Fossa,Bones, Iliac Crest,Crest Bone, Iliac,Crest Bones, Iliac,Crest, Iliac,Crests, Iliac,Fossa, Iliac,Iliac Crest Bones,Iliac Crests,Iliums
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001859 Bone Neoplasms Tumors or cancer located in bone tissue or specific BONES. Bone Cancer,Cancer of Bone,Cancer of the Bone,Neoplasms, Bone,Bone Neoplasm,Neoplasm, Bone
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D050278 Finger Phalanges Bones that make up the SKELETON of the FINGERS, consisting of two for the THUMB, and three for each of the other fingers. Bones of Fingers,Finger Bones,Phalanges of Fingers,Bones, Finger,Fingers Bones,Phalanges, Finger
D050279 Metacarpal Bones The five cylindrical bones of the METACARPUS, articulating with the CARPAL BONES proximally and the PHALANGES OF FINGERS distally. Metacarpals,Bones, Metacarpal

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