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Journal of Bone and Soft Tissue Tumors (JBST) is the official Journal of The Indian Musculo Skeletal Oncology Society
Histopathology of Giant-cell Tumor of Bone – Current Concept
Vol 3 | Issue 2 | Sep-Dec 2017 | Page 2-5| Sanjeev Shah.
Authors: Sanjeev Shah [1].
[1] Department of Pathology, Unipath Laboratory Specialty Ltd, Beside JMC House, Ahmedabad, Gujarat, India.
Address of Correspondence
Dr. Sanjeev Shah,
102, First floor, Sanoma Plaza, Opp. Parimal Garden, Beside JMC House, Ellisbridge, Ahmedabad – 380006, Gujarat, India.
E-mail: dcp72002@yahoo.com
Abstract
GCTB is a primary osteolytic bone tumor which can recurrence, undergo metastasis, and malignant transformation. Current understanding of molecular pathogenesis of GCTB particularly RANK on osteoclast-like GCs and RANKL on stromal cells and development of newer agents such as denosumab and INF-α has tremendously impacted management of patients with GCTB.
Keywords: Giant-cell tumor of bone histopathology, current concept.
References
1. Turcotte RE. Giant cell tumor of bone. OrthopClin North Am 2006;37:35-51.
2. Georgi PG, Svetoslav S, Iva ND, Boycho L. Giant cell tumor of bone: Current review of morphological, clinical, radiological, and therapeutic characteristics. J Clin Exp Investig 2014;5:475-85.
3. Nielsen GP, Andrew ER, Vikram D, Francis JH, Susan VK, Daniel IR. Diagnostic Pathology Bone: Amirsys; 2013. p. 371-95.
4. Fletcher CD, Bridge JA, Hogendoorn P, Mertens F. WHO Classification of Tumours of Soft Tissue and Bone. 4th ed. Lyon: France IARC Press; 2013. p. 321-4.
5. Dominkus M, Ruggieri P, Bertoni F, Briccoli A, Picci P, Rocca M, et al. Histologically verified lung metastases in benign giant cell tumours–14 cases from a single institution. Int Orthop 2006;30:499-504.
6. Kay RM, Eckardt JJ, Seeger LL, Mirra JM, Hak DJ. Pulmonary metastasis of benign giant cell tumor of bone. Six histologically confirmed cases, including one of spontaneous regression. Clin Orthop Relat Res 1994;302:219-30.
7. Gamberi G, Benassi MS, Böhling T, Ragazzini P, Molendini L, Sollazzo MR, et al. Prognostic relevance of C-myc gene expression in giant-cell tumor of bone. J Orthop Res 1998;16:1-7.
8. Schoedel KE, Greco MA, Stetler-Stevenson WG, Ohori NP, Goswami S, Present D, et al. Expression of metalloproteinases and tissue inhibitors of metalloproteinases in giant cell tumor of bone: An immunohistochemical study with clinical correlation. Hum Pathol 1996;27:1144-8.
9. Hoch B, Inwards C, Sundaram M, Rosenberg AE. Multicentric giant cell tumor of bone. Clinicopathologic analysis of thirty cases. J Bone Joint Surg Am 2006;88:1998-2008.
10. Dhillon MS, Prasad P. Multicentric giant cell tumour of bone. ActaOrthopBelg 2007;73:289-99.
11. Bertoni F, Bacchini P, Staals EL. Malignancy in giant cell tumor of bone. Cancer 2003;97:2520-9.
12. Nascimento AG, Huvos AG, Marcove RC. Primary malignant giant cell tumor of bone: A study of eight cases and review of the literature. Cancer 1979;44:1393-402.
13. Anract P, De Pinieux G, Cottias P, Pouillart P, Forest M, Tomeno B, et al. Malignant giant-cell tumours of bone. Clinico-pathological types and prognosis: A review of 29 cases. Int Orthop 1998;22:19-26.
14. Dickson BC, Li SQ, Wunder JS, Ferguson PC, Eslami B, Werier JA, et al. Giant cell tumor of bone express p63. Mod Pathol 2008;21:369-75.
15. Behjati S, Tarpey PS, Presneau N, Scheipl S, Pillay N, Van Loo P, et al. Distinct H3F3A and H3F3B driver mutations define chondroblastoma and giant cell tumor of bone. Nat Genet 2013;45:1479-82.
16. Akpalo H, Lange C, Zustin J. Discovered on gastrointestinal stromal tumour 1 (DOG1): A useful immunohistochemical marker for diagnosing chondroblastoma. Histopathology 2012;60:1099-106.
17. Cleven AG, Briaire-de Bruijn I, Szuhai K, Bovee JV. DOG1 expression in giant-cell-containing bone tumours. Histopathology 2016;68:938-45.
18. Althof PA, Ohmori K, Zhou M, Bailey JM, Bridge RS, Nelson M, et al. Cytogenetic and molecular cytogenetic findings in 43 aneurysmal bone cysts: Aberrations of 17p mapped to 17p13.2 by fluorescence in situhybridization. Mod Pathol 2004;17:518-25.
19. Oliveira AM, Perez-Atayde AR, Dal Cin P, Gebhardt MC, Chen CJ, Neff JR, et al. Aneurysmal bone cyst variant translocations upregulate USP6 transcription by promoter swapping with the ZNF9, COL1A1, TRAP150, and OMD genes. Oncogene 2005;24:3419-26.
20. Kim Y, Nizami S, Goto H, Lee FY. Modern interpretation of giant cell tumor of bone: Predominantly osteoclastogenic stromal tumor. Clin Orthop Surg 2012;4:107-16.
21. López-Pousa A, Martín Broto J, Garrido T, Vázquez J. Giant cell tumour of bone: New treatments in development. Clin Transl Oncol 2015;17:419-30.
22. Xu SF, Adams B, Yu XC, Xu M. Denosumab and giant cell tumour of bone-a review and future management considerations. Curr Oncol 2013;20:e442-7.
23. Branstetter DG, Nelson SD, Manivel JC, Blay JY, Chawla S, Thomas DM, et al. Denosumab induces tumor reduction and bone formation in patients with giant-cell tumor of bone. Clin Cancer Res 2012;18:4415-24.
24. Heymann D. Anti-RANKL therapy for bone tumours: Basic, pre-clinical and clinical evidences. J Bone Oncol 2012;1:2-11.
25. Roux S, Amazit L, Meduri G, Guiochon-Mantel A, Milgrom E, Mariette X, et al. RANK (receptor activator of nuclear factor kappa B) and RANK ligand are expressed in giant cell tumors of bone. Am J ClinPathol 2002;117:210-6.
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Systemic Adjuvant Therapies in the Management of Giant Cell Tumor of Bone: Current State of Understanding and Practice
Vol 3 | Issue 2 | Sep-Dec 2017 | Page 6-9 | Shekhar Kumta, Carol Lau, K C Wong.
Authors: Shekhar Kumta [1], Carol Lau [1], K C Wong [2].
[1] Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong,
[2] Department of Orthopaedics& Traumatology, The Prince of Wales Hospital, Hong Kong.
Address of Correspondence
Dr. Shekhar Kumta,
103-E, Learning Resource Centre, Block A, Prince of Wales Hospital, Shatin, Hong Kong.
Email: shekharkumta@gmail.com
Abstract
GCT of bone is a locally aggressive bone-destroying tumor. The primary neoplastic tumor cell is a RANKL over expressing cell that drives osteoclast recruitment and activation, ultimately leading to bone resorption at the site of the lesion. Osteoclast driven destruction in GCT may be ameliorated with the use of drugs such as Bisphophonates, which target Osteoclasts as well as the primary neoplastic stromal cells. Denusomab, is a monoclonal antibody against RANKL and it has a dramatic effect on Osteoclasts. Adjuvant therapies have reduced recurrence rates in GCT of bone, but uncertainties remain as to the optimum dose-intensity of the drugs and the duration of treatment.
Keywords: Tumor, bone destruction, Giant Cell Tumor of Bone.
References
1. Balke M, Schremper L, Gebert C, Ahrens H, Streitbuerger A, Koehler G, et al. Giant cell tumor of bone: Treatment and outcome of 214 cases. J Cancer Res ClinOncol2008;134:969-78.
2. Becker WT, Dohle J, Bernd L, Braun A, Cserhati M, Enderle A, et al. Local recurrence of giant cell tumor of bone after intralesional treatment with and without adjuvant therapy. J Bone Joint Surg Am 2008;90:1060-7.
3. Malawer MM, Bickels J, Meller I, Buch RG, Henshaw RM, Kollender Y, et al. Cryosurgery in the treatment of giant cell tumor. A long-term followup study. ClinOrthopRelat Res 1999;359:176-88.
4. Marcove RC, Weis LD, Vaghaiwalla MR, Pearson R. Cryosurgery in the treatment of giant cell tumors of bone: A report of 52 consecutive cases. ClinOrthopRelat Res 1978;134:275-89.
5. Gortzak Y, Kandel R, Deheshi B, Werier J, Turcotte RE, Ferguson PC, et al. The efficacy of chemical adjuvants on giant-cell tumour of bone. An in vitro study. J Bone Joint Surg Br 2010;92:1475-9.
6. Lin WH, Lan TY, Chen CY, Wu K, Yang RS. Similar local control between phenol- and ethanol-treated giant cell tumors of bone. ClinOrthopRelat Res 2011;469:3200-8.
7. Theoleyre S, Wittrant Y, Tat SK, Fortun Y, Redini F, Heymann D, et al. The molecular triad OPG/RANK/RANKL: Involvement in the orchestration of pathophysiological bone remodeling. Cytokine Growth Factor Rev 2004;15:457-75.
8. Yasuda H, Shima N, Nakagawa N, Yamaguchi K, Kinosaki M, Mochizuki S, et al. Osteoclast differentiation factor is a ligand for osteoprotegerin/osteoclastogenesis-inhibitory factor and is identical to TRANCE/RANKL. Proc Natl AcadSci U S A 1998;95:3597-602.
9. Yasuda H, Shima N, Nakagawa N, Mochizuki SI, Yano K, Fujise N, et al. Identity of osteoclastogenesis inhibitory factor (OCIF) and osteoprotegerin (OPG): A mechanism by which OPG/OCIF inhibits osteoclastogenesisin vitro. Endocrinology 1998;139:1329-37.
10. Huang L, Xu J, Wood DJ, Zheng MH. Gene expression of osteoprotegerin ligand, osteoprotegerin, and receptor activator of NF-kappaB in giant cell tumor of bone: Possible involvement in tumor cell-induced osteoclast-like cell formation. Am J Pathol2000;156:761-7.
11. Nancollas GH, Tang R, Phipps RJ, Henneman Z, Gulde S, Wu W, et al. Novel insights into actions of bisphosphonates on bone: Differences in interactions with hydroxyapatite. Bone 2006;38:617-27.
12. Rogers MJ, Crockett JC, Coxon FP, Mönkkönen J. Biochemical and molecular mechanisms of action of bisphosphonates. Bone 2011;49:34-41.
13. Ebetino FH, Francis MD, Rogers MJ, Russell RG. Mechanisms of actions of etidronate and other bisphosphonates. Rev ContempPharmacother1998;9:233-43.
14. Balke M, Campanacci L, Gebert C, Picci P, Gibbons M, Taylor R, et al. Bisphosphonate treatment of aggressive primary, recurrent and metastatic giant cell tumour of bone. BMC Cancer 2010;10:462.
15. Tse LF, Wong KC, Kumta SM, Huang L, Chow TC, Griffith JF, et al. Bisphosphonates reduce local recurrence in extremity giant cell tumor of bone: A case-control study. Bone 2008;42:68-73.
16. Yu X, Xu M, Xu S, Su Q. Clinical outcomes of giant cell tumor of bone treated with bone cement filling and internal fixation, and oral bisphosphonates. Oncol Lett 2013;5:447-51.
17. Cheng YY, Huang L, Lee KM, Xu JK, Zheng MH, Kumta SM, et al. Bisphosphonates induce apoptosis of stromal tumor cells in giant cell tumor of bone. Calcif Tissue Int2004;75:71-7.
18. Coleman RE, Major P, Lipton A, Brown JE, Lee KA, Smith M, et al. Predictive value of bone resorption and formation markers in cancer patients with bone metastases receiving the bisphosphonate zoledronic acid. J ClinOncol2005;23:4925-35.
19. Weitzman R, Sauter N, Eriksen EF, Tarassoff PG, Lacerna LV, Dias R, et al. Critical review: Updated recommendations for the prevention, diagnosis, and treatment of osteonecrosis of the jaw in cancer patients-May 2006. Crit Rev OncolHematol2007;62:148-52.
20. Perazella MA, Markowitz GS. Bisphosphonate nephrotoxicity. Kidney Int2008;74:1385-93.
21. Kostenuik PJ, Nguyen HQ, McCabe J, Warmington KS, Kurahara C, Sun N, et al. Denosumab, a fully human monoclonal antibody to RANKL, inhibits bone resorption and increases BMD in knock-in mice that express chimeric (murine/human) RANKL. J Bone Miner Res 2009;24:182-95.
22. Thomas D, Henshaw R, Skubitz K, Chawla S, Staddon A, Blay JY, et al. Denosumab in patients with giant-cell tumour of bone: An open-label, Phase 2 study. Lancet Oncol2010;11:275-80.
23. Lewiecki EM, Miller PD, McClung MR, Cohen SB, Bolognese MA, Liu Y, et al. Two-year treatment with denosumab (AMG 162) in a randomized Phase 2 study of postmenopausal women with low BMD. J Bone Miner Res 2007;22:1832-41.
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Giant Cell Tumor Symposium Part 1
Vol 3 | Issue 1 | May- Aug 2017 | page:2 | Dr. Mandip Shah
Author: Dr. Mandip Shah [1].
[1] Sparsh Orthopedic Oncology Clinic. Medicare Building 9th Floor, ,
B/H Town Hall, Ashram Road, 380006 – Ahmedabad., India
Address of Correspondence
Dr. Mandip Shah
Sparsh Orthopedic Oncology Clinic. Medicare Building 9th Floor, ,
B/H Town Hall, Ashram Road, 380006 – Ahmedabad., India
Email: mandipshah@gmail.com
Giant Cell Tumor Symposium Part 1
Giant cell tumor is one of the commonest bony tumor that is not only encountered by Orthopaedic Oncology surgeons but by general orthopaedic surgeons. This is the reason weneed to keep ourselves updated about what new is happening with this specific bone tumor. We have conceptualise this symposium in Journal of Bone and soft tissue tumors in two parts. This first part has two articles. The first article is by Dr Bhavin Jhankaria and his team on Current concepts of imaging in GCT. This article brings up all the latest updates from a radiologist point of view and also keeps in mind the practical issues faced by the surgeons. The second article is an update on intralesional curettage by Dr Manish Agarwal. Intralesional Curettage is the most important and most commonly used surgical technique for treatment of GCT and Dr Agarwal details the surgical techniques as well as the current updates on the concept and results. With these two articles most impoartant areas of GCT are covered. The aspect of adjuvant therapies and other complex topics will be covered in the next part of the symposium Please write to us regarding your suggestions and opinions.
Tissue Tumors May- Aug 2017; 3(1):2.
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Resection and Arthrodesis of the Knee Joint by Different Modalities for Aggressive Giant Cell Tumors of Bone
Volume 3 | Issue 1 | May- Aug 2017 | Page 17-21 | Y. J. Mahale, Shubham Mishra, Sagar Chinchole
Authors: Y. J. Mahale [1], Shubham Mishra [1], Sagar Chinchole [1].
[1]Departmnet of Orthopedics, ACPM Medical College, Dhule, Maharashtra, India,
Address of Correspondence
Dr. Shubham Mishra,
ACPM medical college ,
Dept of orthopaedics, room no 604,
pg boys hostel ,saakri road dhule, 424001
Email : shaggyurfrnd28@gmail.com
Abstract
Purpose: The aim is to evaluate the functional outcomes inCampanacci Grade 3 giant cell tumor (GCT)of distal femur and proximal tibia treated with wide resection and arthrodesis with different implants used such as long intramedullary interlocking nail(n=11),long Kuntscher nail(n=2), and DCP plate(n=3) andto compare the outcomes and functional results of arthrodesis with arthroplasty which were done elsewere.GCTis a aggressive benign bone tumor[1]seen in young patients with a normal life expectancy. Campanacci Grade 3 tumors and recurrent tumors require wide resection[1,2].Arthrodesis is an alternativeoptions for reconstruction in Campanacci Grade 3,though Arthroplasty is ideal option for campannci Grade 3 tumors.
Methods: Criteria included 16 patients of Campanacci Grade 3 GCT in which 14 male and 2 female around aged between 20and 60 years with a mean age of 30 years underwent resection and arthrodesis of the knee for GCTs of bone involving the distal femur(n=7) or proximal tibia(n= 9).After wide resection,2 struts were fashioned from the harvested fibula of thesame side and inserted into medullary canal at the resected ends of the tibia and femur.Cancellous bone grafts were taken from thesame side of theiliac crest.Hemicylindrical graft was taken from anteriorpart of either distal femur or proximal tibia. A long intramedullary interlocking nail was inserted inretrograde fashion through piriformis fossa to distal tibia.Cancellous bone grafts[2,3]were placed transversely along the struts and circumferentially over the host-graft junctions.For other patients, long Kuntscher nail and DCP plate with K-wirewere used.Results of arthrodesis were evaluated those in which long intramedullary interlocking nail(n=11), long Kuntscher nail(n=2),and DCP (n=3).Outcomes and complications were evaluated and compared with those of endoprosthetic arthroplasty reported elsewhere.
Results: Patients were followed up for a mean of 12 years. All patients were ofCampanacciGrade 3.The mean size of tumors was 12-10-7cm.All patients achieved arthrodesis with intramedullary interlocking nail, Kuntscher nail,and plating.A total number of patient (n=16).The mean bone union time was 12-14 weeks. There was no loss of alignment,loosening, and no implant breakage. The mean musculoskeletal tumor society[5] score was 27(87%of full score). The complications were evaluated in which patients were having skin necrosis(n=3),skin infection (n=2),and peroneal nerve injury(n=1).
Conclusions: In aggressiveCampanacciGrade 3 GCT around theknee joint,arthrodesis [6,7]withlong intramedullary interlocking nail provides good results. Longintramedullary interlocking nailing in arthrodesisprovides high fusion rates, minimal shortening,and rotational stability as compared to plate fixation. Arthrodesis is acost-effective method as compared to arthroplasty in economically constrained population of developing nations and shows good functional outcomes with acceptable morbidity.
Keywords: Giant cell tumor, arthrodesis, intramedullary interlocking nail, hemicylindrical graft, fibula transposition, bone transplantation.
References
1. Dahlin DC, Cupps RE, Johnson EW. Giant-cell tumor: A study of 195 cases. Cancer 1970;25(5):1061-1070.
2. Sung HW, Kuo DP, Shu WP, Chai YB, Liu CC, Li SM. Giant-cell tumor of bone: Analysis of two hundred and eight cases in Chinese patients. J Bone Joint Surg Am 1982;64(5):755-761.
3. Yip KM, Leung PC, Kumta SM. Giant cell tumor of bone. ClinOrthopRelat Res 1996;323:60-64.
4. Mendenhall WM, Zlotecki RA, Scarborough MT, Gibbs CP, Mendenhall NP. Giant cell tumor of bone. Am J ClinOncol 2006;29(1):96-99.
5. Blackley HR, Wunder JS, Davis AM, White LM, Kandel R, Bell RS. Treatment of giant-cell tumors of long bones with curettage and bone-grafting. J Bone Joint Surg Am 1999;81(6):811-820.
6. Lim YW, Tan MH. Treatment of benign giant cell tumours of bone in Singapore. Ann Acad Med Singapore 2005;34(3):235-237.
7. Wang HC, Chien SH, Lin GT. Management of grade III giant cell tumors of bones. J SurgOncol 2005;92(1):46-51.
8. Malawer M. Proximal tibia resection with endoprosthetic reconstruction. In: Makawer MM, Sugarbaker PH, editors. Musculoskeletal Cancer Surgery. Dordrecht: Kluwer Academic Publishers; 2001. p. 485-505.
9. Turcotte RE. Giant cell tumor of bone. OrthopClin North Am 2006;37(1):35-51.
10. Khalil el SA, Younis A, Aziz SA, El Shahawy M. Surgical management for giant cell tumor of bones. J Egypt NatlCancInst 2004;16(3):145-152.
11. Myers GJ, Abudu AT, Carter SR, Tillman RM, Grimer RJ. Endoprosthetic replacement of the distal femur for bone tumours: Long-term results. J Bone Joint Surg Br 2007;89(4):521-526.
12. Maruthainar K, Dunstan ER, Hamilton PD, Unwin P, Cannon SR, Briggs TW. Massive endoprostheses for giant cell tumours of the distal femur: A 12-year follow-up. Knee 2006;13(5):378-381.
13. Bhangu AA, Kramer MJ, Grimer RJ, O’Donnell RJ. Early distal femoral endoprosthetic survival: Cemented stems versus the Compress implant. IntOrthop 2006;30(6):465-472.
14. Biau D, Faure F, Katsahian S, Jeanrot C, Tomeno B, Anract P. Survival of total knee replacement with a megaprosthesis after bone tumor resection. J Bone Joint Surg Am 2006;88(6):1285-1293.
15. Sharma S, Turcotte RE, Isler MH, Wong C. Cemented rotating hinge endoprosthesis for limb salvage of distal femur tumors. ClinOrthopRelat Res 2006;450:28-32.
16. Ahlmann ER, Menendez LR, Kermani C, Gotha H. Survivorship and clinical outcome of modular endoprosthetic reconstruction for neoplastic disease of the lower limb. J Bone Joint Surg Br 2006;88(6):790-795.
17. Langlais F, Belot N, Ropars M, Lambotte JC, Thomazeau H. The long-term results of press-fit cemented stems in total knee prostheses. J Bone Joint Surg Br 2006;88(8):1022-1026.
18. Morgan HD, Cizik AM, Leopold SS, Hawkins DS, Conrad EU. Survival of tumormegaprostheses replacements about the knee. ClinOrthopRelat Res 2006;450:39-45.
19. D’Aubigne RM, Dejouany JP. Diaphyseo-epiphyseal resection for bone tumour at the knee. J Bone Joint Surg Br 1959;40:385-395.
20. Enneking WF, Eady JL, Burchardt H. Autogenous cortical bone grafts in the reconstruction of segmental skeletal defects. J Bone Joint Surg Am 1980;62(7):1039-1058.
21. Enneking WF, Shirley PD. Resection-arthrodesis for malignant and potentially malignant lesions about the knee using an intramedullary rod and local bone grafts. J Bone Joint Surg Am 1977;59(2):223-236.
22. Enneking WF, Eady JL, Burchardt H. Autogenous cortical bone grafts in the reconstruction of segmental skeletal defects. J Bone Joint Surg Am 1980;62(7):1039-1058.
23. Enneking WF, Shirley PD. Resection-arthrodesis for malignant and potentially malignant lesions about the knee using an intramedullary rod and local bone grafts. J Bone Joint Surg Am 1977;59(2):223-236.
24. Enneking WF, Dunham W, Gebhardt MC, Malawar M, Pritchard DJ. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. ClinOrthopRelat Res 1993;286:241-246.
25. Vidyadhara S, Rao SK. A novel approach to juxta-articular aggressive and recurrent giant cell tumours: Resection arthrodesis using bone transport over an intramedullary nail. IntOrthop 2007;31(2):179-184.
26. Wada T, Usui M, Nagoya S, Isu K, Yamawaki S, Ishii S. Resection arthrodesis of the knee with a vascularised fibular graft. Medium-to long-term results. J Bone Joint Surg Br 2000;82(4):489-493.
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A Case Series on Osteochondroma of Scapula
Volume 3 | Issue 1 | May- Aug 2017 | Page 14-16 | Rohit Santhanam, Mohan Ganesan
Authors: Rohit Santhanam [1], Mohan Ganesan [1].
[1]Department of Orthopaedics, Kilpauk Medical College and Hospital, Kilpauk, Chennai, Tamil Nadu, India,
Address of Correspondence
Dr. Rohit Santhanam,
11/8 Roja street , brindavan nagar, koyambedu,
Chennai – 600092,Tamil Nadu, India.
Email: drrohitsanthanam@gmail.com
Abstract
Background: Osteochondroma is the most common primary bone tumor. It commonly occurs in young people and the growth of the tumor ceases with maturity. The most common site is in long bones, namely, femur, tibia,and humerus.Osteochondroma of flat bones especially is a rarity. These tumors can arise from both the dorsal and the ventral surface. Snapping scapula syndrome is attributed to the variants arising from the ventral surface. We have evaluated five cases involving scapula and treated them successfully.
Materials and Methods: Five cases of osteochondroma were evaluated, treated, and followed up after thorough evaluation clinically and radiographically.
Observation: All the five cases were treated successfully after thorough evaluation with no signs of recurrence. Patients had symptomatic relief and snapping scapula syndrome was relieved once the tumorwas removed with theexcellent functional outcome.
Keywords: Osteochondroma, scapula, snapping scapula syndrome.
References
1. Sivananda P, Rao BK, Kumar PV, Ram GS. Osteochondroma of the ventral scapula causing scapular static winging and secondary rib erosion. J Clin Diagn Res 2014;8:LD03-LD05.
2. Chillemi C, Franceschini V, Ippolito G, Pasquali R, Diotallevi R, Petrozza V, et al. Osteochondroma as a cause of scapular winging in an adolescent: A case report and review of the literature. J Med Case Rep 2013;7:220.
3. Bloch AM, Nevo Y, Ben-Sira L, Harel S, Shahar E. Winging of the scapula in a child with hereditary multiple exostoses. Pediatr Neurol 2002;26(1):74-76.
4. Kwon OS, Kelly JI. Delayed presentation of osteochondroma on the ventral surface of the scapula. Int J Shoulder Surg 2012;6:61-63.
5. Vela P, Andrés Collado M, Agulló Antón A, Cerezal Garrido J, Hoz J. Clinical Images: Osteochondroma leading to snapping scapula syndrome. Arthritis Rheum 2010;62:1838.
6. Orth P, Anagnostakos K, Fritsch E, Kohn D, Madry H. Static winging of the scapula caused by osteochondroma in adults: A case series. J Med Case Rep 2012;6:363.
7. Lesprit E, Le Huec JC, Moinard M. Snapping scapula syndrome-conservative and surgical treatment. Eur J Orthop Surg Traumatol 2001;11:51-54.
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Current Concepts in Imaging of Giant Cell Tumor of Bone
Volume 3 | Issue 1 | May – Aug 2017 | Page 3-7 | Khushboo Pilania, Bhavin Jankharia
Authors: Khushboo Pilania [1], Bhavin Jankharia [1].
[1]Consultant Radiologists, Picture This by Jankharia, Mumbai, Maharashtra, India.
Address of Correspondence
Dr. Bhavin Jankharia,
Bhaveshwar Vihar, 383 S V P Rd,
Mumbai – 400004, Maharashtra, India.
E-mail: bhavin@jankharia.com
Abstract
Giant cell tumor(GCT) of bone is a tumor of giant cell proliferation that usually affects men and women in the thirdand fourthdecades. Typical cases have straight-forward imaging appearances. Atypical cases may resemble many other benign and sometimes malignant lesions. Plain radiographs and magnetic resonance imaging (MRI) are the mainstay of diagnosis, followed by biopsy and histology.Positron emission tomography/computed tomography (CT) has a limited role to play.Aneurysmal bone cyst transformation within GCTs is known. This may change the imaging appearance. GCTs may be multifocal, locally aggressive, and may metastasize to nodes and lungs.Treatment with drugs like denosumab also changes the appearance on radiographs and MRI. Post-operative imaging can be a challenge, and picking up recurrence also requires high-quality radiographs, MRIs, and CT scans.
Keywords: Giant cell tumor, giant cell tumor, bone neoplasm, computed tomography scan, magnetic resonance imaging, plain radiograph.
References
1. Chakarun CJ, Forrester DM, Gottsegen CJ, Patel DB, White EA, Matcuk GR Jr, et al. Giant cell tumor of bone: Review, mimics, and new developments in treatment. Radiographics 2013;33:197-211.
2. Dorfman HD, Czerniak B. Giant-cell lesions. In: Dorfman HD, Czerniak B, editors. Bone Tumors. St Louis, Mo: Mosby; 1998. p. 559-606.
3. Stacy GS, Peabody TD, Dixon LB. Mimics on radiography of giant cell tumor of bone. AJR Am J Roentgenol 2003;181:1583-9.
4. Cooper AS, Travers B. Surgical Essays. London, England: Cox Longman & Co.; 1818.
5. Murphey MD, Nomikos GC, Flemming DJ, Gannon FH, Temple HT, Kransdorf MJ, et al. From the archives of AFIP. Imaging of giant cell tumor and giant cell reparative granuloma of bone: Radiologic-pathologic correlation. Radiographics 2001;21:1283-309.
6. Manaster BJ, Doyle AJ. Giant cell tumors of bone. Radiol Clin North Am 1993;31:299-323.
7. Moser RP Jr., Kransdorf MJ, Gilkey FW, Manaster BJ. From the archives of the AFIP. Giant cell tumor of the upper extremity. Radiographics 1990;10:83-102.
8. Puri A, Agarwal MG, Shah M, Jambhekar NA, Anchan C, Behle S, et al. Giant cell tumor of bone in children and adolescents. J Pediatr Orthop 2007;27:635-9.
9. Joyner CJ, Quinn JM, Triffitt JT, Owen ME, Athanasou NA. Phenotypic characterization of mononuclear and multinucleated cells of giant cell tumor of bone. Bone Miner 1992;16:37-48.
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