Sobti Anshul, Agrawal Pranshu, Agarwala Sanjay, Agarwal Manish
Department of Orthopaedics, P.D Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, India.
Arch Bone Jt Surg. 2016 Jan;4(1):2-9.
Giant Cell tumors (GCT) are benign tumors with potential for aggressive behavior and capacity to metastasize. Although rarely lethal, benign bone tumors may be associated with a substantial disturbance of the local bony architecture that can be particularly troublesome in peri-articular locations. Its histogenesis remains unclear. It is characterized by a proliferation of mononuclear stromal cells and the presence of many multi- nucleated giant cells with homogenous distribution. There is no widely held consensus regarding the ideal treatment method selection. There are advocates of varying surgical techniques ranging from intra-lesional curettage to wide resection. As most giant cell tumors are benign and are located near a joint in young adults, several authors favor an intralesional approach that preserves anatomy of bone in lieu of resection. Although GCT is classified as a benign lesion, few patients develop progressive lung metastases with poor outcomes. Treatment is mainly surgical. Options of chemotherapy and radiotherapy are reserved for selected cases. Recent advances in the understanding of pathogenesis are essential to develop new treatments for this locally destructive primary bone tumor.
骨巨细胞瘤(GCT)是具有侵袭性行为和转移能力的良性肿瘤。尽管很少致命,但良性骨肿瘤可能会导致局部骨结构的严重破坏,这在关节周围部位可能会特别棘手。其组织发生仍不清楚。它的特征是单核基质细胞增殖以及存在许多分布均匀的多核巨细胞。关于理想治疗方法的选择,目前尚无广泛共识。从病灶内刮除术到广泛切除术,有不同手术技术的支持者。由于大多数骨巨细胞瘤是良性的,且位于年轻成年人的关节附近,一些作者倾向于采用保留骨解剖结构而非切除术的病灶内治疗方法。尽管骨巨细胞瘤被归类为良性病变,但仍有少数患者会发生进行性肺转移,预后较差。治疗主要是手术治疗。化疗和放疗仅用于特定病例。对发病机制认识的最新进展对于开发针对这种局部破坏性原发性骨肿瘤的新治疗方法至关重要。