Israelski Ronald, Obi Ted Nnamno, Pean Christian Alexander, Hippolyte Jean Wildric, Durham John, Zuckerman Lee M
Designated Institutional Official (DIO), Orange Regional Medical Center, Middletown, NY, United States; Orthopedic Relief Services International (ORSI), United States; Orthopaedic Surgery, Touro College of Medicine, United States.
Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Int J Surg Case Rep. 2021 Mar;80:105686. doi: 10.1016/j.ijscr.2021.105686. Epub 2021 Feb 22.
Giant cell tumor of bone (GCTB) is a benign-aggressive tumor that has a high-rate of recurrence with curettage resection alone. Patients with GCTB in underserved regions of the world can have progression of the tumor with significant disability due to a lack of specialty care. We present a case of an en bloc resection of an aggressive, recurrent GCTB of the radius with excellent function and no evidence of tumor recurrence two years after surgery.
A 22-year-old right-hand dominant female in Haiti developed an aggressive recurrence of a giant cell tumor of bone (GCTB) of the distal radius. Treatment consisted of en bloc resection of the distal radius with the proximal row of the carpus and centralization of the ulna. At two-year follow-up, the patient maintained good functional capacity with no clinical or radiological evidence of recurrence.
GCTB can cause significant destruction of the bone and articular surface if not treated adequately. Treatment options should be considered carefully in underserved regions of the world based on the resources available. This case exemplifies that complex limb-salvage surgery is possible when coordination of care between international and local surgeons is provided with an emphasis on continuity of care post-operatively.
En bloc resection with centralization of the ulna remains a viable technique to address aggressive GCTB of the distal radius and can be appropriate in resource-limited settings.
骨巨细胞瘤(GCTB)是一种具有侵袭性的良性肿瘤,仅行刮除术切除后复发率很高。在世界上医疗资源匮乏地区的骨巨细胞瘤患者,由于缺乏专科护理,肿瘤可能进展并导致严重残疾。我们报告一例对侵袭性复发性桡骨骨巨细胞瘤进行整块切除的病例,术后两年功能良好且无肿瘤复发迹象。
一名22岁、惯用右手的海地女性,桡骨远端骨巨细胞瘤出现侵袭性复发。治疗方法为整块切除桡骨远端及腕骨近端排,并使尺骨中心化。在两年的随访中,患者保持了良好的功能状态,无临床及影像学复发证据。
如果治疗不当,骨巨细胞瘤可导致骨骼和关节面的严重破坏。在世界上医疗资源匮乏地区,应根据现有资源仔细考虑治疗方案。该病例表明,当国际和当地外科医生之间提供护理协调,并强调术后护理的连续性时,复杂的肢体挽救手术是可行的。
尺骨中心化整块切除术仍是治疗桡骨远端侵袭性骨巨细胞瘤的可行技术,在资源有限的情况下也适用。