title: Management of aggressive giant cell tumor of calcaneal bone: A case report.
abstract: BACKGROUND
  Prevalence of giant cell tumor (GCT) at atypical locations like bones of the feet are rare, seen in <1% of cases. GCT may have aggressive features, including cortical expansion or destruction with a soft-tissue component. Difficult diagnosis most often followed with complicated management and high recurrence rate remains a challenge that is rarely reported.
  
  
  METHODS
  We presented a case of forty-six-year-old male patient with giant cell tumor of the right calcaneus Campanacci 3 with secondary aneurysmal bone cyst (ABC). Wide excision total calcaneoctomy, followed by reconstruction bone defect using femoral head allograft and soft tissue coverage with sural flap had been done.
  
  
  CONCLUSIONS
  Conservative surgery with careful curettage and placement of bone cement should be considered the treatment of choice when feasible. However, aggressive GCTs may require wide excision and reconstruction or may be amputation. We decided to do salvage surgery since: traditionally curettage is not possible, adequately wide resection of local tumor could be achieved, neurovascular bundle was not involved, and also bone and soft tissue reconstructions could be done. In addition, he refused for amputation.
  
  
  CONCLUSIONS
  Wide excision total calcaneoctomy, bone allograft reconstruction and soft tissue coverage with sural flap is a good option for surgical management in aggressive GCT of calcaneus instead of amputation.
authors.affiliation: Department of Orthopaedic and Traumatology Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia. Electronic address: fauzikamal@yahoo.com.
authors.forename: Achmad Fauzi
authors.initials: AF
authors.lastname: Kamal
authors.affiliation: Department of Orthopaedic and Traumatology Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
authors.forename: Agus
authors.initials: A
authors.lastname: Waryudi
authors.affiliation: Department of Orthopaedic and Traumatology Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
authors.forename: Zuhri
authors.initials: Z
authors.lastname: Effendi
authors.affiliation: Department of Anatomic Pathology Cipto Mangunkusumo National Central Hospital/Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
authors.forename: Evelina
authors.initials: E
authors.lastname: Kodrat
keywords: Bone allograft; Calcaneoctomy; Giant cell tumor; Sural flap; Wide excision