[Giant-cell tumor of the hand: midterm results in five patients].
OBJECTIVE
Giant-cell bone tumors are benign but have great potential for recurrence. Frequently observed in epiphyseal areas of tubular bones, these tumors are rarely found in hand localizations. We examined the characteristic features of giant-cell tumors of the hand and analyzed the pertinence of surgical treatment. We noted complications, consequences of recurrence and later operations on the same tumor site in five cases.


METHODS
Five patients treated between 1973 and 2000 for giant-cell tumors involving the hand bones were reviewed retrospectively. Mean age was 41.6 years and mean follow-up was 7.8 years. The surgical procedure was curettage for two, curettage with bone graft for two and amputation for one. The Enneking score was noted.


RESULTS
Pain was the main symptom, with local swelling in several cases. At 7.8 years follow-up recurrence was noted for four of the five tumors. Two patients were treated for a second recurrence. Amputation of the forearm was required for one recurrence affecting soft tissue. Mean time between two consecutive recurrences was three months. In all six episodes of recurrent tumor were treated. These five patients had a total of ten operations. There were no cases of metastasis nor multicentric foci.


CONCLUSIONS
Treatment of giant-cell tumors involving the hand bones is designed to eradicate the tumor and also protect hand function while keeping in mind the aggressive nature of these benign tumors. Surgical alternatives for radical treatment can include wide resection, resection of the ray and amputation.
Ozalp
T
T
Service de chirurgie orthopédique et traumatologique, CHU de Celal Bayar, Izmir, 45020 Manisa, Turquie. tackino@yahoo.fr
Yercan
H
H
Okçu
G
G
Ozdemir
O
O
Coskunol
E
E
Bégué
T
T
Calli
I
I
D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D001859:Bone Neoplasms / Q000601:surgery*; D016025:Bone Transplantation; D003475:Curettage; D005260:Female; D050278:Finger Phalanges / Q000601:surgery; D005500:Follow-Up Studies; D005870:Giant Cell Tumors / Q000601:surgery*; D050276:Hand Bones / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D012189:Retrospective Studies; D012983:Soft Tissue Neoplasms / Q000601:surgery; D013933:Thumb / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome