Giant Cell Tumour of Bone

Benign tumour arising from the giant cells of the bone marrow

Aetiology

  • Aetiology unknown

Pathophysiology

  • Occur in the metaphyseal region, tend to involve the epiphysis and can extend to the subchondral bone adjacent to the joint
  • Can be locally aggressive

Clinical presentation

  • Painful mass/swelling
  • Commonly occur around the knee and in the distal radius but can occur in other long bones, the pelvis and the spine
  • May cause pathological fracture

Investigations

  • X-ray - characteristic 'soap bubble' appearance
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  • Histology - consist of multi-nucleated giant cells
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Management

  • Intralesional excision with use of phenol, bone cement or liquid nitrogen to destroy remaining tumour material and reduce the risk of recurrence
  • Very aggressive lesions with cortical destruction may need joint replacement
  • Considered benign but 5% can metastasize to the lung with benign pulmonary GCT