Teja Tarun, Shrivastava Sandeep, Singh Raghvendra, Nalhe Shreenivas, Rathod Vinit
Department of Orthopaedics, Acharya Vinoba Bhave Rural Hospital, Datta Meghe Institute of Higher Education and Research, Sawangi (Meghe), Wardha, Maharashtra, India.
J Orthop Case Rep. 2025 Jun;15(6):136-140. doi: 10.13107/jocr.2025.v15.i06.5692.
Giant cell tumor (GCT), also known as osteoclastoma, is an osteolytic, predominantly benign yet locally aggressive neoplasm that manifests in young adults within the meta-epiphyseal region of long bones, specifically the distal femur, proximal tibia, distal radius, and proximal humerus, in that order of prevalence. GCT of the metacarpal (MC) exhibits distinct characteristics compared to other long bones. It exhibits more aggressive behavior with involvement of the entire length of the MC and expansion into the soft tissue. Literature reports an incidence of 1.7% for GCT of MC.
We report a 43-year-old female who visited the hospital with left hand swelling for 8 months that gradually progressed and localized mass over the dorsum of the medial aspect of the hand. MRI revealed an enchondroma-like benign bone lesion of the fourth MC in the meta diaphyseal area. The patient was scheduled for an en bloc excision with bone grafting from fibula with fusion of MC and MC phalangeal joints and K-wire fixation at the MC region. On exposure, the gross appearance revealed the lesion to be likely GT, and the histological findings confirmed the diagnosis of GCT, demonstrating multinucleated large cells and mononucleated stromal cells.
The meta-diaphysis of small hand bone GCT is a rare occurrence at the site of MC. This case is hence reported for the same reason.
骨巨细胞瘤(GCT),又称破骨细胞瘤,是一种溶骨性、主要为良性但具有局部侵袭性的肿瘤,好发于年轻成年人长骨的干骺端区域,具体依次为股骨远端、胫骨近端、桡骨远端和肱骨近端。掌骨(MC)的骨巨细胞瘤与其他长骨的骨巨细胞瘤表现出不同的特征。它表现出更具侵袭性的行为,可累及掌骨全长并向软组织扩展。文献报道掌骨骨巨细胞瘤的发病率为1.7%。
我们报告一名43岁女性,因左手肿胀8个月就诊,肿胀逐渐加重,手部内侧背侧出现局限性肿块。磁共振成像(MRI)显示第四掌骨干骺端区域有一个类似内生软骨瘤的良性骨病变。患者计划接受整块切除,取自腓骨进行骨移植,并融合掌骨和掌指关节,在掌骨区域进行克氏针固定。术中暴露病变时,大体外观显示该病变可能为骨巨细胞瘤,组织学检查结果证实为骨巨细胞瘤,可见多核大细胞和单核基质细胞。
手部小骨骨巨细胞瘤发生于掌骨部位较为罕见。因此,出于同样原因报告了本病例。