Puri Ajay, Agarwal Manish
Dept. of Orthopedic Oncology, Tata Memorial Hospital, Mumbai, India.
Indian J Orthop. 2007 Apr;41(2):101-8. doi: 10.4103/0019-5413.32039.
Giant cell tumor (GCT) of bone though one of the commonest bone tumors encountered by an orthopedic surgeon continues to intrigue treating surgeons. Usually benign, they are locally aggressive and may occasionally undergo malignant transformation. The surgeon needs to strike a balance during treatment between reducing the incidence of local recurrence while preserving maximal function.Differing opinions pertaining to the use of adjuvants for extension of curettage, the relative role of bone graft or cement to pack the defect and the management of recurrent lesions are some of the issues that offer topics for eternal debate.Current literature suggests that intralesional curettage strikes the best balance between controlling disease and preserving optimum function in the majority of the cases though there may be occasions where the extent of the disease mandates resection to ensure adequate disease clearance.An accompanying treatment algorithm helps outline the management strategy in GCT.
骨巨细胞瘤（GCT）虽是骨科医生最常遇到的骨肿瘤之一，但仍让治疗医生感到困惑。它们通常为良性，却具有局部侵袭性，偶尔可能发生恶性转变。外科医生在治疗过程中需要在降低局部复发率和保留最大功能之间找到平衡。关于使用辅助剂扩大刮除范围、骨移植或骨水泥填充缺损的相对作用以及复发病变的处理等不同观点，是引发永恒争论的一些问题。当前文献表明，在大多数情况下，病灶内刮除术在控制疾病和保留最佳功能之间达到了最佳平衡，尽管在某些情况下，疾病的范围要求进行切除以确保充分清除病灶。随附的治疗算法有助于概述骨巨细胞瘤的管理策略。
