Patel Rahul, Parmar Rahul, Agarwal Srishty
Orthopedics and Traumatology, New Civil Hospital, Surat, IND.
General Medicine, New Civil Hospital, Surat, IND.
Cureus. 2023 Jul 20;15(7):e42197. doi: 10.7759/cureus.42197. eCollection 2023 Jul.
Introduction Giant cell tumor (GCT) or bony tumor mainly involving long bones of arms and legs is very rarely associated with the small bones of hands and feet. Due to its nonspecific signs and symptoms, it is not easy to diagnose based on clinical findings; therefore, histopathological evidence is required to confirm it. Method A total of 16 patients with positive histopathological bone lesions enriched with giant cells were included in our study. After a complete evaluation of their case records, the required radiological assessment was carried out. Campanacci's method of staging was used to evaluate the advancement of lesions. The Musculoskeletal Tumour Society (MSTS) score was recorded postoperatively. All the patients were followed up for a mean duration of 2.8 years until they were lost to follow-up. Result The result of the current study shows that 62.5% of our patients presented in their twenties and 81.25% of patients came at a reasonably advanced stage. Hand and foot were involved in 1:1 cases. Patients were treated by one of the following options: extended curettage with bone graft or cement, wide excision, or en bloc resection. Phenol, a neoadjuvant, was used in all patients. Two of our patients (6.25%) who underwent curettage with bone graft showed up with recurrence during follow-up - one was then treated with wide excision and the other with amputation. Conclusion Giant cell tumors should undoubtedly be aggressively approached with the goal of preserving limb function while reducing recurrence risk to as minimal as possible. GCT of hand is more aggressive comparatively and should be treated accordingly.
引言 骨巨细胞瘤（GCT）或主要累及四肢长骨的骨肿瘤很少与手足小骨相关。由于其体征和症状不具特异性，基于临床发现不易诊断；因此，需要组织病理学证据来确诊。方法 本研究纳入了16例组织病理学检查显示骨病变中有丰富巨细胞的患者。在全面评估他们的病例记录后，进行了所需的放射学评估。采用坎帕纳奇分期方法评估病变进展情况。术后记录肌肉骨骼肿瘤学会（MSTS）评分。所有患者平均随访2.8年，直至失访。结果 本研究结果显示，62.5%的患者为二十多岁，81.25%的患者就诊时处于相当晚期。手足受累情况为1:1。患者接受了以下一种治疗方案：带骨移植或骨水泥的扩大刮除术、广泛切除术或整块切除术。所有患者均使用了新辅助药物苯酚。我们中有2例（6.25%）接受带骨移植刮除术的患者在随访期间出现复发——其中1例随后接受了广泛切除术，另1例接受了截肢术。结论 骨巨细胞瘤无疑应积极治疗，目标是保留肢体功能，同时将复发风险降至最低。手部骨巨细胞瘤相对更具侵袭性，应相应进行治疗。
