[Giant cell tumor of bone. An evaluation of 87 patients].
OBJECTIVE
Giant cell tumor (GCT) of bone is a very peculiar and interesting tumor due to of its biological behavior and the phenomenon of pulmonary metastases of a histologically benign tumor. We present the results of a retrospective study.


METHODS
Between 1965 and 2002 we treated 87 patients, 54 women and 33 men, for a GCT of bone. The average age of the patients was 28.2 (range 8-72) years. The median follow-up time was 91 months. 63 patients (72.4%) were hospitalized with a primary tumor. Twelve of these patients (19 %) had a pathological fracture. 24 patients (27.6%) presented with local recurrence. 7 tumors were malignant GCT of bone, 80 tumors were benign. According to the classification of Campanacci, 9 patients (10.3%) were diagnosed in stage I, 42 (48.3%) in stage II, and 36 (41.4%) in stage III. Surgical procedures were intralesional curettage and packing with cement in 36 patients, and bone-grafting in 7. In 35 cases we performed a wide resection, and in nine an amputation.


RESULTS
Local recurrence was observed in 11 patients (12.6%), all of them were benign GCT. Local recurrences were followed by an intralesional curettage and bone-grafting in three cases (42.8%), packing with cement in seven (19.4%). Three patients with local recurrence (27.3%) also had synchronous pulmonary metastases. All patients diagnosed with benign GCT are still alive. 3 out of 7 patients with malignant GCT died from progression of metastatic disease.


CONCLUSIONS
To reduce the risk of local recurrence and pulmonary metastases, we recommend an adjuvant therapy of GCT.
Tunn
P-U
PU
Klinik für Chirurgie und Chirurgische Onkologie, Charité Universitätsmedizin Berlin. tunn@rrk.charite-buch.de
Schlag
P M
PM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D001843:Bone Cements / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D016025:Bone Transplantation; D001842:Bone and Bones / Q000473:pathology / Q000601:surgery; D002648:Child; D003952:Diagnostic Imaging; D005121:Extremities / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000473:pathology / Q000601:surgery; D018212:Giant Cell Tumor of Bone / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D015996:Survival Rate
D001843:Bone Cements