Functional outcome of campanacci grade 3 giant cell tumours of distal radius after resection and reconstruction with ulnar translocation technique: a case series

Reconstruction after en-bloc resection can be challenging in cases of Campanacci grade 3 giant cell tumour of the bone (GCTB) of the distal radius. Here, the authors examined the outcomes of patients with Campanacci grade 3 GCTBs of the distal radius who underwent wrist arthrodesis and reconstruction with ulnar translocation.

Material and methods

This case series was a retrospective single-centre study. Clinical assessments regarding the functional status and complications were follow-up. The functional results were evaluated using the Musculoskeletal Tumor Society (MSTS) and Disability of Arm, Shoulder, and Hand (DASH) Score. Paired t-tests were used to compare the MSTS and DASH scores separately before and after the operation. Statistical differences were considered significant at P less than 0.05.

Results

Seven patients were included in this study. The mean follow-up period was 14.43±8.08 months. The average length of tumour resection was 9.78±2.88 cm. The average range of motion of the involved forearm was 82.66° of supination and 81.54° of pronation. The average MSTS score was 11.71±2.21 before and 25.14±2.41 after the operation (P<0.05). The average DASH score on admission was 40.14±14.66, which decreased to 9.02±4.23 after the operation (P<0.05). Of the seven cases, one case had a recurrence, and one patient had radioulnar synostosis.

Conclusion

Wrist arthrodesis combined with ulnar translocation can be considered a simple and effective reconstruction method with preservation of function after en-bloc resection of Campanacci grade 3 GCTB of the distal radius. It provides good functional outcomes with low complication rates.

A remote metastatic giant cell tumour to the skull

This case discusses an unusual presentation of remote metastatic giant cell tumour presenting as a seizure.

Pathogenesis of Osteosclerotic Change Following Treatment with an Antibody Against RANKL for Giant Cell Tumour of the Bone

BACKGROUND

Giant cell tumours (GCTs) of the bone are intermediate tumours that are locally aggressive. Denosumab, an antibody against receptor activator of nuclear factor kappa-B ligand (RANKL), was recently developed; however, it induces osteosclerotic change through an unknown mechanism. We determined whether osteosclerotic change could be induced by neoplastic stromal cells of giant cell tumours (GCTs).

PATIENTS AND METHODS

Participants included four patients with GCT of the bone who were treated with neoadjuvant denosumab. Expression of alkaline phosphatase (ALP), osteocalcin (OCN), RANKL and histone H3K36 trimethylation were assessed through immunohistochemistry of biopsy and surgical specimens.

RESULTS

OCN expression was significantly elevated after denosumab treatment, whereas ALP and RANKL expressions were not significantly elevated. Immunofluorescence staining revealed OCN expression and H3K36 trimethylation while their co-localisation was confirmed in the surgical specimens.

CONCLUSION

Denosumab promoted OCN expression and might induce the osteogenic differentiation of GCT stromal cells.