title: Local recurrence of giant cell tumour of bone after intralesional treatment with and without adjuvant therapy, a single institution case series.
abstract: BACKGROUND
  Giant cell tumour (GCT) of bone is generally a benign tumour composed of mononuclear stromal cells and characteristic multinucleated giant cells that exhibit osteoclastic activity. It usually develops in long bones but can occur in unusual locations. The typical appearance is a lytic lesion with a well-defined but non-sclerotic margin that is eccentric in location, extends near the articular surface, and occurs in patients with closed physes.
  
  
  OBJECTIVE
  The current study was planned to summarise our experiences with GCTB, and to evaluate individual effect of bone cement, high-speed burring and hydrogen per oxide (H2O2) on local recurrence. GCT can mimic or be mimicked by other benign or malignant lesions at both radiological evaluation and histological analysis. In the past, the mainstay of treatment was surgical, primarily consisting of curettage with cement placement, with recurrence rates of 15%-25%. Recurrence is suggested by development of progressive lucency at the cement-bone interface.
  
  
  RESULTS
  Of the 21 patients who started the study, 4(19%) were lost to follow-up, and 17(81%) represented the final study sample. Of them, 16(94.11%) patients underwent the curettage procedure with adjuvant therapy and reconstruction with bone grafts taken from iliac crest. In 3(26.3%) patients, no adjuvant was used. Total of 6 (42.1%) patients had local recurrence and 3(50%) of them were those who were treated without any adjuvant; 2(33.3%) with phenol and 1(16.6%) with PMMA.
  
  
  CONCLUSIONS
  The results of the present study suggest that an "aggressive curettage" with the use of adjuvant reduces the recurrence rate in a disease whose aggressiveness is not easy to predict.
authors.affiliation: Department of Orthopedic Surgery, Allied Hospital, Punjab Medical College Faisalabad, Pakistan.
authors.forename: Rana Dawood
authors.initials: RD
authors.lastname: Ahmad Khan
authors.affiliation: Department of Orthopedic Surgery, Allied Hospital, Punjab Medical College Faisalabad, Pakistan.
authors.forename: Usama Bin
authors.initials: UB
authors.lastname: Saaed
authors.affiliation: Department of Orthopedic Surgery, Allied Hospital, Punjab Medical College Faisalabad, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Zain-Ur-Rehman
authors.affiliation: Graduate Student, Clinical Research Department of Experimental Medicine, McGill University, Montreal, Canada.
authors.forename: Muhammad Qasim
authors.initials: MQ
authors.lastname: Saeed
authors.affiliation: Department of Orthopedic Surgery, Allied Hospital, Punjab Medical College Faisalabad, Pakistan.
authors.forename: Ajmal
authors.initials: A
authors.lastname: Yasin
keywords: Bone tumour, Giant cell tumour, Extremity, Surgery, Curettage, Resection, Wide excision.