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Mohamed Ali PS, Yan YY, Tan TJ. Clinics in diagnostic imaging (209). Giant cell tumour of the left ring finger proximal phalanx. Singapore Med J 2021; 62:75-81. [PMID: 33655316 DOI: 10.11622/smedj.2021017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | - Yet Yen Yan
- Department of Diagnostic Radiology, Changi General Hospital, Singapore
| | - Tien Jin Tan
- Department of Diagnostic Radiology, Changi General Hospital, Singapore
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Damert HG, Kober M, Mehling I. Custom-made wrist prothesis (UNI-2™) in a patient with giant cell tumor of the distal radius: 10-year follow-up. Arch Orthop Trauma Surg 2020; 140:2109-2114. [PMID: 32876750 DOI: 10.1007/s00402-020-03593-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/16/2020] [Indexed: 11/28/2022]
Abstract
Wrist endoprosthesis is still an exceptional indication compared to the prosthesis of large joints, especially when a rescue surgery procedure of the wrist is no longer possible and the complete wrist arthrodesis is to be considered the ultima ratio. However, a suspended function in the wrist is accompanied by a significant restriction in the patient`s daily life. Using the fourth-generation endoprosthesis, the situation regarding long-term results for the hand has already improved. This means that a durability of more than 6 years is no longer a rarity. Defect situations in joints, in particular those which occur after tumor, still pose a greater challenge. If autologous reconstructions cannot be performed, custom-made prostheses can be considered as very rare indications for joint reconstruction. While these have been used for years on large joints such as shoulder, elbow, knee and hip, they have only been described on the hand in particular cases. We report the 10-year follow-up of implantation of a custom-made wrist prothesis (UNI-2™, KMI, Germany) in a 36-year-old patient with tumorous destruction of the distal radius by a giant cell tumor.
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Affiliation(s)
- H G Damert
- Klinik für Plastische, Ästhetische und Handchirurgie, HELIOS-Bördeklinik, Kreiskrankenhaus 4, 39387, Oschersleben, Germany.
| | - M Kober
- Klinik für Plastische, Ästhetische und Handchirurgie, HELIOS-Bördeklinik, Kreiskrankenhaus 4, 39387, Oschersleben, Germany
| | - I Mehling
- St. Vinzenz-Krankenkaus Hanau gGmbH, Am Frankfurter Tor 25, 63450, Hanau, Germany
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Jones NF, Graham DJ. Radical Resection of a Recurrent Giant Cell Tumor of the Distal Ulna and Immediate Reconstruction With a Distal Radio-Ulnar Joint Implant Arthroplasty. Hand (N Y) 2020; 15:727-731. [PMID: 31965863 PMCID: PMC7543204 DOI: 10.1177/1558944719895779] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Giant cell tumors (GCTs) of the distal ulna are rare. Despite being benign, they can be locally aggressive and may recur following conventional treatment by curettage and bone grafting. Salvage reconstructive options after failed conventional treatment include Darrach resection, Suave-Kapandji procedure, hemi-arthroplasty, or total joint arthroplasty. Methods: We discuss reconstruction options for the distal radio-ulnar joint following tumor resection, and present the outcomes of a constrained distal radio-ulnar prosthesis in a 29-year-old male following resection of a distal ulna GCT. Results: Reconstruction of the distal radio-ulnar joint by a constrained prothesis yielded excellent functional outcomes following resection of a GCT of the distal ulna. Conclusions: This case demonstrates that successful oncologic and functional outcomes can be achieved by radical resection of a recurrent GCT of the distal ulna and reconstruction with a constrained total joint arthroplasty.
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Affiliation(s)
- Neil F. Jones
- University of California, Los Angeles, USA,Neil F. Jones, Department of Orthopaedic Surgery, Ronald Reagan UCLA Medical Center, University of California, Los Angeles, 757 Westwood Plaza, Los Angeles, CA 90095, USA.
| | - David J. Graham
- Gold Coast University Hospital, Southport, Queensland, Australia
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Haseeb A, Singh VA, Jayalakshmi P. Can Giant Cell Tumor of the Bone Occur in the Skeletally Immature? J Am Podiatr Med Assoc 2020; 110:436382. [PMID: 32556225 DOI: 10.7547/19-030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Giant cell tumor (GCT) of the bone is a benign, locally aggressive neoplasm that has a high tendency for local recurrence. It usually has a higher incidence in the third decade of life. This is a retrospective review of a case with histologic confirmation of GCT in a skeletally immature patient involving the metatarsal bone, which is a rare site. At our institution, 1.3% of skeletally immature patients had GCT of the bone. From an extensive literature review, only four cases of GCT of the metatarsal bone in the skeletally immature were identified. Giant cell tumor in a skeletally immature patient can be confused for an aneurysmal bone cyst because of similar radiologic findings. Giant cell tumor of the bone can occur in an immature skeleton and should be sought out as a differential diagnosis despite being rare.
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Affiliation(s)
- Amber Haseeb
- Department of Orthopaedic Surgery, National Orthopaedic Center of Excellence for Research and Learning, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Vivek Ajit Singh
- Department of Orthopaedic Surgery, National Orthopaedic Center of Excellence for Research and Learning, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Pailoor Jayalakshmi
- Department of Medical Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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A management strategy for giant cell tumor of the metacarpal: A single-center series of 11 cases. J Clin Orthop Trauma 2020; 11:657-661. [PMID: 32684706 PMCID: PMC7355077 DOI: 10.1016/j.jcot.2020.05.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 05/26/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Primary giant cell tumor (GCT) arising from bones of hand are rare to occur. Metacarpals are often the most common site of involvement among hand bones. There are no uniform guidelines for treatment of GCT involving metacarpals due to lack of relevant literature. OBJECTIVE To suggest a management strategy for GCT involving metacarpals. METHODS Retrospective review of cases of GCT involving metacarpals over a period of 15 years from 2005 to 2019 managed at department of Orthopaedics, All India Institute of Medical Sciences, New Delhi. RESULTS A total of 12 cases of GCT involving metacarpal were included, out of which one was lost to follow-up. Four cases were recurrent, and seven were primary at the time of surgery. All the patients were operated with wide excision of the tumor. In seven patients reconstruction of the metacarpal and MCPJ was done using fibular strut graft and silastic artificial joint, while in two patients, MCPJ arthrodesis was performed using fibula and/or iliac crest bone graft. In another two patients, the MCPJ was reconstructed using reversed vascularised toe transfer. Mean follow up of the patients was 3.22 ± 2.07 years. Mean Quick DASH score at latest follow-up of patients operated with silastic joint reconstruction, reversed vascularised toe transfer and arthrodesis of MCP joints were 30.5 ± 9.5, 25 ± 2.3 and 39.8 ± 3.4 respectively. Local recurrence occurred only in one patient at one year after surgery. All the patients were pain free at latest follow-up with quite functional and cosmetically acceptable hand. CONCLUSION Reversed vascularised metatarsal transfer has obtained better functional results compared to reconstruction with fibular grafting and silicone joint replacement but due to technical difficulties, vascularised joint transfer may not be performed in every setting and there is risk of donor site morbidities with this technique. Our strategy for the treatment of GCT involving metacarpal was to do vascularised joint transfer or arthrodesis for border digits and reconstruction with silicone joint for central digits.
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Thiounn A, Guerre E, Szymanski C, Maynou C, Fontaine C. Two cases of distal ulna giant cell tumors treated by extensive resection, prosthetic reconstruction and stabilization using the brachioradialis tendon. HAND SURGERY & REHABILITATION 2017; 36:419-422. [PMID: 29054719 DOI: 10.1016/j.hansur.2017.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 07/31/2017] [Accepted: 09/13/2017] [Indexed: 10/18/2022]
Abstract
Aggressive giant cell tumors are rare at the distal ulna. We report the results of two patients who were treated surgically using a distal ulna prosthesis stabilized by ligament reconstruction with the brachioradialis tendon. At the maximum follow-up of 18months, the two patients were satisfied. Joint range of motion and functional scores were improved. X-rays showed no recurrence or subluxation; however gradual impingement of the ulnar notch of radius by the prosthesis was visible. Our technique seems to be a viable alternative when compared with the treatments described in other published case reports.
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Affiliation(s)
- A Thiounn
- Service d'orthopédie, hôpital Roger-Salengro, CHRU de Lille, rue du Professeur-Emile-Laine, 59037 Lille cedex, France.
| | - E Guerre
- Service d'orthopédie, hôpital Roger-Salengro, CHRU de Lille, rue du Professeur-Emile-Laine, 59037 Lille cedex, France; Laboratoire d'anatomie, faculté de médecine Henri-Warembourg, Université de Lille 2, place de Verdun, 59045 Lille cedex, France
| | - C Szymanski
- Service d'orthopédie, hôpital Roger-Salengro, CHRU de Lille, rue du Professeur-Emile-Laine, 59037 Lille cedex, France
| | - C Maynou
- Service d'orthopédie, hôpital Roger-Salengro, CHRU de Lille, rue du Professeur-Emile-Laine, 59037 Lille cedex, France
| | - C Fontaine
- Service d'orthopédie, hôpital Roger-Salengro, CHRU de Lille, rue du Professeur-Emile-Laine, 59037 Lille cedex, France; Laboratoire d'anatomie, faculté de médecine Henri-Warembourg, Université de Lille 2, place de Verdun, 59045 Lille cedex, France
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Damert HG, Altmann S, Kraus A. Custom-made wrist prosthesis in a patient with giant cell tumor of the distal radius. Arch Orthop Trauma Surg 2013; 133:713-9. [PMID: 23474969 DOI: 10.1007/s00402-013-1692-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Treatment for giant cell tumors of the distal radius is challenging when motion is to be preserved. As standard wrist prostheses typically do not achieve favorable results, we treated a 36-year-old man with giant cell tumor of the distal radius with a new, custom-made implant. METHODS A custom-made wrist prosthesis with a long shaft was designed according to the patient's X-ray findings. After complete tumor resection, the prosthesis was subsequently implanted into the distal radius without complications. RESULTS Two months after surgery, range of motion was 30°-0-25° for extension/flexion, 10°-0-5° for ulnar/radial abduction, 80°-0-0 for pronation/supination, complete range of motion for the fingers, and a grip strength of 6 kg. Two years after surgery, implant position was still correct and range of motion was 45°-0-10° for extension/flexion, 10°-0-20° for ulnar/radial abduction, and 80°-0-10° for pronation/supination. Grip strength was 16 kg, and DASH score was 25 compared to 39 before surgery. The patient returned to work as a craftsman. CONCLUSION Custom-made wrist prostheses could become a practical option in patients with large defects of the distal radius who desire to preserve wrist motion.
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Affiliation(s)
- Hans-Georg Damert
- Department of Plastic, Aesthetic and Hand Surgery, Otto-von-Guericke University, Leipziger Strasse 44, Magdeburg, Germany
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Gutiérrez-Santiago MM, González-Arteaga J, Hidalgo-Ovejero AM. [Giant cell tumours in a pyramidal bone: a clinical case and a review of the literature]. Rev Esp Cir Ortop Traumatol (Engl Ed) 2012; 56:149-52. [PMID: 23594757 DOI: 10.1016/j.recot.2011.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Revised: 09/06/2011] [Accepted: 09/07/2011] [Indexed: 10/28/2022] Open
Abstract
Giant cell tumours (GCT) of the bone are benign, but locally invasive tumours. We present a new case of carpus GCT, involving the triquetrum. The diagnosis required a prior biopsy before doing the block resection. This treatment is the best option to avoid recurrences. We review the literature on this particular lesion in the carpus bone.
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Affiliation(s)
- M M Gutiérrez-Santiago
- Unidad de Miembro Superior, Servicio de Traumatología y Ortopedia, Hospital Virgen del Camino-Clínica Ubarmin, Pamplona, Navarra, España.
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Giant cell tumours in a pyramidal bone: A clinical case and a review of the literature. Rev Esp Cir Ortop Traumatol (Engl Ed) 2012. [DOI: 10.1016/j.recote.2011.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Ahn JH, Choy WS, Kim HY, Kim HS. Midfoot reconstruction for a large, aggressive giant-cell tumor: a case report. J Bone Joint Surg Am 2011; 93:e133(1-6). [PMID: 22262393 DOI: 10.2106/jbjs.j.01676] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Jae Hoon Ahn
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul, 137-040, South Korea.
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Gracia I, Proubasta IR, Trullols L, Peiró A, Moya E, Cortés S, Buezo O, Majó J. Distal radioulnar joint prosthesis for the treatment of giant cell tumor of the distal ulna: a case report and literature review. Strategies Trauma Limb Reconstr 2011; 6:103-6. [PMID: 21773775 PMCID: PMC3150648 DOI: 10.1007/s11751-011-0113-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Accepted: 07/09/2011] [Indexed: 11/24/2022] Open
Abstract
Giant cell tumor (GCT) of the distal end of the ulna is an uncommon site for primary bone tumors. When it occurs, en-bloc resection of the distal part of the ulna with or without reconstruction stabilization of the ulnar stump is the recommended treatment. We present a case of a 56-year-old man with a GCT of the distal ulna treated successfully with an en-bloc resection of the distal ulna with reconstruction using radioulnar joint prosthesis. Although the experience with this type of treatment is limited, implantation of a metallic prosthesis to replace the distal part of the ulna can also be considered as a salvage procedure for the treatment of this difficult pathology.
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Affiliation(s)
- Isidre Gracia
- Orthopaedic Department, Hospital Santa Cruz Y San Pablo, Barcelona, Spain
| | | | - Laura Trullols
- Orthopaedic Department, Hospital Santa Cruz Y San Pablo, Barcelona, Spain
| | - Ana Peiró
- Orthopaedic Department, Hospital Santa Cruz Y San Pablo, Barcelona, Spain
| | - Esther Moya
- Orthopaedic Department, Hospital Santa Cruz Y San Pablo, Barcelona, Spain
| | - Sarah Cortés
- Orthopaedic Department, Hospital Santa Cruz Y San Pablo, Barcelona, Spain
| | - Oscar Buezo
- Orthopaedic Department, Hospital Santa Cruz Y San Pablo, Barcelona, Spain
| | - Joan Majó
- Orthopaedic Department, Hospital Santa Cruz Y San Pablo, Barcelona, Spain
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Kotnis NA, Davies AM, Kindblom LG, James SLJ. Giant cell tumour of the triquetrum. Skeletal Radiol 2009; 38:593-5. [PMID: 19294376 DOI: 10.1007/s00256-009-0684-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2009] [Revised: 02/26/2009] [Accepted: 03/02/2009] [Indexed: 02/02/2023]
Abstract
We present details of a case of giant cell tumour of bone (GCTOB) involving the triquetrum. GCTOB arising within the carpus is exceedingly rare and, to our knowledge, this is only the second case of monostotic GCTOB of the triquetrum that has been reported.
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Affiliation(s)
- N A Kotnis
- Department of Radiology, The Royal Orthopaedic Hospital Foundation Trust, Northfield, Birmingham, UK.
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Guedes A, Baptista PPR, Santili C, Yonamine ES, Garcia HRP, Martinez EC. Ressecção ampla e transposição fibular no tratamento do TCG da extremidade distal do rádio. ACTA ORTOPEDICA BRASILEIRA 2009. [DOI: 10.1590/s1413-78522009000300010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Avaliação funcional e oncológica do tratamento do TCG do segmento distal do rádio (estadio B3) mediante ressecção ampla e reconstrução com enxerto autólogo avascular da extremidade proximal da fíbula. MÉTODOS: A função residual foi avaliada mediante escore ISOLS, medida do arco residual global do punho operado, do percentual residual da força de preensão da mão e da preensão entre o polegar e o indicador. O controle oncológico foi avaliado mediante exame clínico do membro operado e avaliação por imagens do punho e do tórax. RESULTADOS: 17 pacientes avaliados, dez do sexo feminino (58,8%) e sete do sexo masculino (41,2%) com idades entre 16 e 61 anos (média de 32,3 anos), todos destros. Na avaliação funcional (ISOLS) observamos 11 resultados excelentes, dois bons e um ruim; os três casos que demandaram artrodese evoluíram com escore excelente. O arco residual global foi de 196,2 ± 116,6º. O arco residual do punho operada correspondeu a 58,9% do controle. A força de preensão da mão correspondeu a 55,4 ± 17,4% do controle. O percentual de "pinça" foi de 80,6 ± 14,8% do controle. Não constatamos recidiva ou metástases nesta casuística. CONCLUSÃO: A técnica propiciou resultados funcionais alentadores, assegurando o retorno dos pacientes às suas atividades. A ausência de recidiva local e/ou metástases, observada inclusive nos pacientes com seguimento mais longo, permite sugerir que a técnica parece ser segura no controle oncológico do tumor.
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Abstract
We report a very unusual presentation of giant cell tumor probably originated on the greater wing of the sphenoid and show a review about the knowledge and the treatment of the lesion in this rare localization. We treated a 48-year-old man with a giant cell tumor of the infratemporal fossa. He presented with a right-side hearing loss and facial pain. The tumor was resected by means of a subtemporal-preauricular approach, and after 12 months of follow-up, the patient is free of recurrence. Giant cell tumors of the skull base are an extremely rare neoplasm, and there is not much information on the literature about the treatment and the prognostic. Wide resection ought to be made, and at the follow-up, the clinician must try to diagnose not only local recurrence but also the possibility of distant metastases to the lung.
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Abstract
OBJECTIVE The proton MR spectroscopic finding of elevated choline has been reported to be useful in the differentiation of malignant from benign musculoskeletal tumors. This study was designed to evaluate the MR spectroscopy features of giant cell tumor (GCT) of the bone, primarily to determine whether the presence of choline is a frequent occurrence in these tumors and whether MR spectroscopy features can be correlated with clinical, radiologic, and histopathologic findings. SUBJECTS AND METHODS MRI, dynamic contrast-enhanced MRI, and proton MR spectroscopy were performed in 33 patients with bone tumors on a 1.5-T MR scanner. Of these, 12 patients who had GCT of the bone form the subject material for this study. Dynamic contrast-enhanced MRI and single-voxel proton MR spectroscopy were performed after preliminary evaluation with radiography. Patients were divided into two groups, those with elevated choline levels and those without a choline peak on MR spectroscopy. The clinical and radiologic features, including the Campanacci stage and dynamic MRI findings, were compared in these two groups. Core biopsy was performed in all patients, and in 10 of 12 patients, histopathologic evaluation of the postoperative resected specimen was also performed. RESULTS Although all 12 tumors were benign on histopathology, four had elevated choline levels. Of these, three (75%) had an aggressive radiographic appearance (Campanacci stage 3). As opposed to this, only three of the eight (37.5%) tumors without a choline peak had an aggressive radiographic appearance. Except for a single case, all tumors showed early enhancement and washout of contrast material on dynamic MRI. CONCLUSION The results of this study indicate that GCT of bone may show raised choline levels on proton MR spectroscopy. This finding is not an indicator of malignancy in these tumors.
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Nishimura K, Satoh T, Maesawa C, Ishijima K, Sato H. Giant cell tumor of the larynx: a case report and review of the literature. Am J Otolaryngol 2007; 28:436-40. [PMID: 17980781 DOI: 10.1016/j.amjoto.2006.11.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2006] [Revised: 11/07/2006] [Accepted: 11/16/2006] [Indexed: 10/22/2022]
Abstract
Giant cell tumors are benign tumors commonly found in the long bones. Rarely, they may occur in the larynx, and patients with such tumors may present with hoarseness and anterior neck swelling. Since Wessely reported the first case of laryngeal giant cell tumor in 1940, 30 cases have been identified. Herein, we present a case of a 31-year-old man with giant cell tumor of the larynx successfully treated via the hemilaryngectomy approach.
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