Kishor Kamal, Jyoti Nitish Jagdish, Kapoor Love, Kumar Venkatesan Sampath, Ansari Tahir, Khan Shah Alam
Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
J Orthop Case Rep. 2024 Dec;14(12):174-179. doi: 10.13107/jocr.2024.v14.i12.5064.
Giant cell tumor (GCT) of the bone, although benign, poses significant challenges due to its locally aggressive nature and high recurrence rates post-surgical intervention. Among skeletal GCTs, those affecting the distal radius present unique difficulties, especially when fungating masses encase vital structures such as blood vessels.
We present a case of a 28-year-old male with a recurring GCT of the distal radius, where limb-preserving surgery was successfully performed despite encasement of the radial artery. Surgical excision followed by wrist arthrodesis utilizing ulnar centralization resulted in satisfactory outcomes, emphasizing the importance of tailored surgical approaches for optimal functional preservation. Despite encountering local recurrence, subsequent excision and reconstruction utilizing vacuum-assisted closure and skin grafting achieved successful limb salvage with no evidence of further recurrence at the 18-month follow-up.
This case study contributes valuable insights into rare limb salvage techniques applicable to challenging GCT presentations, advocating for personalized treatment strategies to mitigate recurrence risk and preserve patient quality of life.
骨巨细胞瘤（GCT）虽为良性肿瘤，但因其局部侵袭性及手术干预后高复发率而带来重大挑战。在骨骼巨细胞瘤中，累及桡骨远端的肿瘤存在独特困难，尤其是当肿瘤呈蕈状肿块包裹诸如血管等重要结构时。
我们报告一例28岁男性复发性桡骨远端巨细胞瘤病例，尽管桡动脉被包裹，但仍成功实施了保肢手术。手术切除后，采用尺骨中心化进行腕关节融合术，取得了满意效果，强调了采用定制手术方法以实现最佳功能保留的重要性。尽管出现局部复发，但随后采用负压封闭引流及皮肤移植进行切除和重建，成功挽救了肢体，在18个月的随访中未发现进一步复发迹象。
本病例研究为适用于具有挑战性的巨细胞瘤表现的罕见肢体挽救技术提供了宝贵见解，倡导采用个性化治疗策略以降低复发风险并保留患者生活质量。
