Gillani Syed Faraz Ul Hassan Shah, Iqbal Yasir, Taqi Muhammad, Ahmad Blouch Tauseef, Iqbal Muhammad, Siddiq Abubakar
Orthopedic Surgery, King Edward Medical University/Mayo Hospital, Lahore, PAK.
Orthopedics, Swat Medical Complex and Teaching Hospital, Swat, PAK.
Cureus. 2020 Dec 7;12(12):e11953. doi: 10.7759/cureus.11953.
To find the recurrence and outcomes of giant cell tumors treated with scooping curettage, burr down technique, phenolization, and bone cement.
We conducted a descriptive case series using a non-probability consecutive sampling technique at the Department of Orthopedics, Lahore General Hospital, Lahore, Pakistan, from May 2014 to June 2018. A total of 40 patients aged between 20 to 40 years with Compannacci grade I, II & III giant cell tumors (GCT) were included and patients unfit for the surgery, those with multiple, recurrent, malignant giant cell tumors, tumors involving the axial skeleton, and previously treated cases were excluded. We recorded the side, site of the tumor, post-operative distal neurovascular status, and recurrence of giant cell tumors. The patients were follow-up in the out-patient department (OPD) at the second week, fourth week, 12th week, 24th week, 48th week, 96th week, and 144th week after the surgery. Side, site of the tumor, and post-operative distal neurovascular status were assessed clinically, and recurrence of the tumors was observed clinically and radiologically.
The mean age of all patients was 25.75±5.74 years. Males were 45% (18) and females were 55% (22). Most (12, 30%) tumors were present in the upper limb, and 22 (70%) were present in the lower limb. The majority (24, 60%) tumors were present around the knee joint. Companacci grade I was five (12.5%), grade II was 14 (35%), and grade III was 21 (52%). There were six (15%) pathological fractures. There was no case of distal neurovascular (DNV) injury, and three patients had a recurrence in two years of follow-up.
Giant cell tumor treated with scooping curettage, burr down technique, phenolization and poly-methyl methacrylate showed 7.5% recurrence. The combined use of local adjuvants in the treatment of giant cell tumors is a safe and effective way to reduce the rate of local recurrence.
探讨采用刮除术、磨钻技术、苯酚处理及骨水泥填充治疗骨巨细胞瘤的复发情况及治疗效果。
2014年5月至2018年6月，我们在巴基斯坦拉合尔拉合尔综合医院骨科采用非概率连续抽样技术进行了一项描述性病例系列研究。纳入40例年龄在20至40岁之间、Compannacci分级为I、II和III级的骨巨细胞瘤（GCT）患者，排除不适合手术的患者、患有多发、复发性、恶性骨巨细胞瘤的患者、累及轴向骨骼的肿瘤患者以及既往接受过治疗的病例。我们记录了肿瘤的侧别、部位、术后远端神经血管状况以及骨巨细胞瘤的复发情况。患者在术后第二周、第四周、第十二周、第二十四周、第四十八周、第九十六周和第一百四十四周在门诊进行随访。通过临床评估肿瘤的侧别、部位以及术后远端神经血管状况，并通过临床和影像学观察肿瘤的复发情况。
所有患者的平均年龄为25.75±5.74岁。男性占45%（18例），女性占55%（22例）。大多数（12例，30%）肿瘤位于上肢，22例（70%）位于下肢。大多数（24例，60%）肿瘤位于膝关节周围。Compannacci I级有5例（12.5%），II级有14例（35%），III级有21例（52%）。有6例（15%）发生病理性骨折。无远端神经血管（DNV）损伤病例，3例患者在两年随访期内复发。
采用刮除术、磨钻技术、苯酚处理及聚甲基丙烯酸甲酯治疗骨巨细胞瘤的复发率为7.5%。在骨巨细胞瘤治疗中联合使用局部辅助剂是降低局部复发率的一种安全有效的方法。
