Rajani Rajiv, Schaefer Lindsay, Scarborough Mark T, Gibbs C Parker
Assistant Professor, Department of Orthopaedics, University of Texas Health Sciences Center San Antonio, San Antonio, TX.
Resident, Department of Orthopaedics, University of Texas Health Sciences Center San Antonio, San Antonio, TX.
J Foot Ankle Surg. 2015 Nov-Dec;54(6):1141-5. doi: 10.1053/j.jfas.2014.08.016. Epub 2014 Oct 28.
Giant cell tumor (GCT) of the bone is a benign primary bone tumor most often treated with intralesional surgery. Most cases occur around the knee; however, rarely, GCT of bone can occur in the foot and ankle. Limited data exist about the outcomes after treatment of GCT in this location. We retrospectively reviewed an orthopedic oncology database from 1970 to 2010 for cases of GCT of the bone, specifically within the foot and ankle bones. After exclusionary criteria were applied, a total of 19 disease sites in 18 patients were included for analysis. Of the 19 disease sites, 10 recurred. Patients, on average, required 1.7 operations per disease site. Of the 18 patients, 10 required ≥2 operations, 3 required ≥3 operations, and 1 required 4 operations. A total of 4 amputations were performed, including 2 below the knee amputations. Of the 10 patients with recurrence, 2 also had evidence of metastatic disease. The recurrence rates of GCT in the foot and ankle bones appear to be greatest after intralesional curettage without the use of cement. Although the recurrence rates are high, intralesional operations with multiple adjuvant therapy can eventually result in cure.
骨巨细胞瘤(GCT)是一种良性原发性骨肿瘤,最常采用病灶内手术治疗。大多数病例发生在膝关节周围;然而,骨巨细胞瘤很少发生在足踝部。关于该部位骨巨细胞瘤治疗后的结果,现有数据有限。我们回顾性分析了1970年至2010年骨科肿瘤数据库中骨巨细胞瘤病例,特别是足踝部骨骼的病例。应用排除标准后,共纳入18例患者的19个病灶进行分析。19个病灶中,10个复发。每个病灶平均需要1.7次手术。18例患者中,10例需要≥2次手术,3例需要≥3次手术,1例需要4次手术。共进行了4次截肢手术,包括2次膝关节以下截肢。10例复发患者中,2例有转移疾病证据。在不使用骨水泥的病灶内刮除术后,足踝部骨骼骨巨细胞瘤的复发率似乎最高。尽管复发率很高,但采用多种辅助治疗的病灶内手术最终可实现治愈。