Mahajan Neetin P, Sadar Amey, G S Prasanna Kumar, Marfatia Ankit, Sangma Sunny M, Kondewar Pranay
Department of Orthopaedics, Grant Government Medical College and sir JJ group of hospitals, Mumbai, Maharashtra, India.
J Orthop Case Rep. 2021 Mar;11(3):29-32. doi: 10.13107/jocr.2021.v11.i03.2074.
Giant cell tumour (GCT) is a benign osteolytic, locally aggressive lesion. Seen in young adults at the epiphysis. The most common site is long bones (85-90%). GCT of the metatarsal in elderly patients is very rare.
A 60-year-old male came with complaints of pain and swelling over right foot dorsal aspect since for the last past one 1 year. There was no history of trauma. X-ray foot showed an osteolytic lesion in the right third metatarsal with thinning of the cortex. MRI and fine-needle aspiration cytology confirmed the diagnosis of GCT. The patient was managed by excision with the 3rd ray amputation. At present, 1.5 years follow-up, the patient is having no pain, difficulty in walking and no evidence of clinical and radiological recurrence .
Giant cell tumours could also present at uncommon sites, and they should be considered in the differential diagnosis of lytic lesions of the metatarsals. Excision with ray amputation of the involved metatarsal helps in complete removal of the lesion and helps in early weight-bearing. This is the viable alternative treatment option in managing the metatarsal GCT in elderly patients.
骨巨细胞瘤（GCT）是一种良性溶骨性、局部侵袭性病变。多见于年轻成年人的骨骺部位。最常见的部位是长骨（85 - 90%）。老年患者跖骨的骨巨细胞瘤非常罕见。
一名60岁男性因右足背疼痛和肿胀前来就诊，症状已持续1年。无外伤史。足部X线显示右第三跖骨有溶骨性病变，皮质变薄。MRI和细针穿刺细胞学检查确诊为骨巨细胞瘤。患者接受了第三跖骨切除及第三跖骨截肢术治疗。目前，随访1.5年，患者无疼痛、行走困难，无临床及影像学复发迹象。
骨巨细胞瘤也可出现在不常见的部位，在跖骨溶骨性病变的鉴别诊断中应考虑到该病。切除受累跖骨并进行跖骨截肢有助于彻底切除病变，并有助于早期负重。这是老年患者跖骨骨巨细胞瘤可行的替代治疗选择。
