Orthopaedic . Radiology . Pathology Conference: Painful distal femur Lesion in a 13-year-old girl

Can Giant Cell Tumor of the Bone Occur in the Skeletally Immature?

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.

What role for radiobiphosphonates bone scintigraphy in the monitoring of an unusual bone giant cell tumor: a case report and literature review

We report the case of 24 years old female patient, followed since ten years ago for bone giant cell tumor (GCT) of the right knee, which was complicated by pulmonary metastases. Surgical treatment and pulmonary metastasectomies have not allowed definitive cure of this disease with the appearance of metachronous bone lesions after eight years of evolution. The literature review confirms the originality of this observation: the age of the patient, the initial and metastasis locations and the occurrence of lung metastases with unfavorable prognosis. Through this clinical case, the authors highlight the role of radiobiphosphonates bone scintigraphy in detecting synchronous or metachronous bone lesions, and in monitoring of these locations under medical treatment.

Giant cell tumour of the femur in a 9-year-old girl, resulting in severe leg length discrepancy

Giant cell tumour of bone (GCTB) is a rare benign tumour noted before physeal closure. GCTB cases in patients younger than 10 years are especially uncommon. The authors report the case of a 9-year-old girl with a GCTB of the distal femur. After initial intralesional excision and curettage of the tumour, local recurrence occurred, which needed two more additional surgeries to treat. The primary tumour and the local relapse invaded the growth plate of the right distal femur, leading to growth disturbance of the femur and requiring leg lengthening using Ilizarov apparatus. Surgeons should note the possibility of this rare condition while treating radiographic lytic lesions even in skeletally immature patients. The occurrence of late limb length discrepancy would be more likely in younger patients.