Treatment and outcome of giant cell tumors of the pelvis.
OBJECTIVE
Giant cell tumors (GCTs) of bone rarely affect the pelvis. We report on 20 cases that have been treated at our institution during the last 20 years.


METHODS
20 patients with histologically benign GCT of the pelvis were included in this study. 9 tumors were primarily located in the iliosacral area, 6 in the acetabular area, and 5 in the ischiopubic area. 8 patients were treated by intralesional curettage and 6 by intralesional resection with additional curettage of the margins. 3 patients with iliacal tumors were treated by wide resection. 2 patients were treated by a combination of external beam irradiation and surgery, and 1 patient solely by irradiation. In addition, 9 patients received selective arterial embolization one day before surgery. Of the 6 patients with acetabular tumors, 1 secondarily received an endoprosthesis and 1 was primarily treated by hip transposition. The patients were followed for a median time of 3 (1-11) years.


RESULTS
1 patient with a pubic tumor developed a local recurrence 1 year after intralesional resection and additional curettage of the margins. The recurrence presented as a small soft tissue mass within the scar tissue of the gluteal muscles and was treated by resection. No secondary sarcoma was detected and none of the patients developed pulmonary metastases or multicentricity. No major complication occurred during surgery.


CONCLUSIONS
We conclude that most GCTs of the pelvis can be treated by intralesional procedures. For tumors of the iliac wing, wide resection can be an alternative. Surgical treatment of tumors affecting the acetabular region often results in functional impairment. Pre-surgical selective arterial embolization appears to be a safe procedure that may reduce the risk of local recurrence.
Balke
Maurice
M
Department of Orthopedic Surgery, University Hospital Muenster, Muenster, Germany. maurice.balke@ukmuenster.de
Streitbuerger
Arne
A
Budny
Tymoteusz
T
Henrichs
Marcel
M
Gosheger
Georg
G
Hardes
Jendrik
J
D000328:Adult; D000368:Aged; D001843:Bone Cements; D001859:Bone Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D016025:Bone Transplantation; D003475:Curettage; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D018212:Giant Cell Tumor of Bone / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome
D001843:Bone Cements