title: The interdisciplinary approach of an aggressive giant cell tumor of bone complicated with a fracture of the distal femur.
abstract: Giant cell tumor of bone (GCTB) represents one of the commonest bone tumors encountered by an orthopedic surgeon. The giant-cell tumor is generally classified as benign but the fast growing rhythm and the aggressive soft-tissue invasion may in some cases demonstrate a malign potential of the tumor. We present the case of an aggressive giant cell tumor in a young patient that was first diagnosed in our emergency department with a fracture of the distal femur after a low energy trauma. With further examinations, we discovered that the tumor was invading the both femoral condyles and was vascularized by three major arterial pedicles. The onset of his problems was the femoral fracture and the changes on the major vessels, muscles and nerves. After an interdisciplinary approach of the patient and a meticulous preoperative planning, we decided to make an extensive total resection of the tumor followed by a complex reconstruction surgery for the bone. A very stable fixation of a vascularized graft allowed the bone to heal even if the surrounded soft-tissue was almost completely invaded by the tumor and removed during the excision. The follow-up of this case demonstrated that using an interdisciplinary approach of the patient with the Plastic Surgery team, we manage to remove the tumor within oncological limits and achieved bone healing with good stability of the distal femur.
authors: Department of Plastic Surgery and Reconstructive Microsurgery, Clinical Emergency Hospital of Bucharest, Romania; dragoszamfirescu@gmail.com.
authors: Iulian Daniel
authors: ID
authors: Vîlcioiu
authors: Dragoş George
authors: DG
authors: Zamfirescu
authors: Ioan
authors: I
authors: Cristescu
authors: Andrei
authors: A
authors: Ursache
authors: Şerban Arghir
authors: ŞA
authors: Popescu
authors: Cosmin Antoniu
authors: CA
authors: Creangă
authors: Ioan
authors: I
authors: Lascăr
mesh_terms: D000328:Adult; D000792:Angiography; D001706:Biopsy; D005264:Femoral Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D018212:Giant Cell Tumor of Bone / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D033183:Interdisciplinary Communication; D007717:Knee / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D009361:Neoplasm Invasiveness; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000473:pathology; D016059:Range of Motion, Articular; D014057:Tomography, X-Ray Computed