Need for a dedicated Musculoskeletal Tumor Registry in India

Vol 3 | Issue 1 | May- Aug 2017 | page:1 | Dr. Yogesh Panchwagh & Dr. Ashok Shyam.

Author: Dr. Yogesh Panchwagh [1], Dr. Ashok Shyam [2,3].

[1]Orthopaedic Oncology Clinic, Pune, India.
[2] Indian Orthopaedic Research Group, Thane, India
[3] Sancheti Institute for Orthopaedics &Rehabilitation, Pune, India

Address of Correspondence
Dr. Yogesh Panchwagh.
Orthopaedic Oncology Clinic, 101, Vasanth plot 29, Bharat Kunj Society -2, Erandwana, Pune – 38, India.
Email: drpanchwagh@gmail.com

Need for a dedicated Musculoskeletal Tumor Registry in India

Registries are one of the most important resources for any disease. Around 200 cancer registries in the world that covering up mere 5% of worlds population was noted in 1999. However no parallel data exists currently but we are sure that number of cancer registries have increased over the period of time.India has an already existing National cancer registry program which was started in 1981 and is still running strong. However we belive that time has now come for a dedicated musculosketal registry in India. The technology has grown rapidly and now we have developed a simple mobile app which can collect most of the registry data in a very simple and user friendly way. We have been working on this concept sicne two years now and have taken inputs from many orthoonco surgeons. The mobile app is finally launched in the public domain and is available on google play store and app store. The app is named ‘MSK Registry’ and It can be downloaded for free by all interested in contributing cases. We would urge everyone to contribute and also write to us for any issues or queries

Regards.
Dr Yogesh Pachwagh
Dr Ashok Shyam

Yogesh Panchwagh & Ashok Shyam

How to Cite this article: Panchwagh Y, Shyam AK. Need for a dedicated Musculoskeletal Tumor
Registry in India. Journal of Bone and Soft Tissue Tumors Sep-Oct 2017; 3(1):1.

A B

(Abstract Full Text HTML) (Download PDF)

 

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.

How to Cite this article: Shah M. Giant Cell Tumor Symposium Part 1. Journal of Bone and Soft
Tissue Tumors May- Aug 2017; 3(1):2.

 

(Abstract Full Text HTML) (Download PDF)

 

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.

How to Cite this article:  Mahale Y. J, Mishra S, Sagar Chinchole S. Resection and Arthrodesis of the Knee Joint by Different Modalities for Aggressive Giant Cell Tumors of Bone. Journal of Bone and Soft Tissue Tumors Jan-Apr 2016;2(1): 17-21.

 

  (Abstract    Full Text HTML)      (Download PDF)

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.

How to Cite this article:  Santhanam R, Ganesan M. A Case Series on Osteochondroma of Scapula. Journal of Bone and Soft Tissue Tumors Jan-Apr 2016;2(1): 14-16.

 

  (Abstract    Full Text HTML)      (Download PDF)

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.
10. Frassica FJ, Sanjay BK, Unni KK, McLeod RA, Sim FH. Benign giant cell tumor. Orthopedics 1993;16:1179-83.
11. Kafchitsas K, Habermann B, Proschek D, Kurth A, Eberhardt C. Functional results after giant cell tumor operation near knee joint and the cement radiolucent zone as indicator of recurrence. Anticancer Res 2010;30:3795-9.
12. Turcotte RE. Giant cell tumor of bone. Orthop Clin North Am 2006;37:35-51.
13. Arnold RT, van Holsbeeck MT, Mayer TG, Mott MP, Koch SR. Best cases from the AFIP: Necrotic giant cell tumor of bone manifesting with pathologic fracture. Radiographics 2011;31:93-8.
14. Turcotte RE, Wunder JS, Isler MH, Bell RS, Schachar N, Masri BA, et al. Giant cell tumor of long bone: A Canadian sarcoma group study. Clin Orthop Relat Res 2002;397:248-58.
15. Mendenhall WM, Zlotecki RA, Scarborough MT, Gibbs CP, Mendenhall NP. Giant cell tumor of bone. Am J Clin Oncol 2006;29:96-9.
16. Dahlin DC. Caldwell lecture. Giant cell tumor of bone: Highlights of 407 cases. AJR Am J Roentgenol 1985;144:955-60.
17. Bandyopadhyay R, Biswas S, Bandyopadhyay SK, Ray MM. Synchronous multicentric giant cell tumor. J Cancer Res Ther 2010;6:106-8.
18. Dhillon MS, Prabhudev Prasad A, Virk MS, Aggarwal S. Multicentric giant cell tumor involving the same foot: A case report and review of literature. Indian J Orthop 2007;41:154-7.
19. Varshney A, Rao H, Sadh R. Multicentric GCT of tarsal bones in an immature skeleton: A case report with review of literature. J Foot Ankle Surg 2010;49:399.
20. Novais EN, Shin AY, Bishop AT, Shives TC. Multicentric giant cell tumor of the upper extremities: 16 years of ongoing disease. J Hand Surg Am 2011;36:1610-3.
21. Okamoto Y, Mathew S, Daw NC, Neel MD, McCarville MB, Dome JS, et al. Giant cell tumor of bone with pulmonary metastases. Med Pediatr Oncol 2003;41:454-9.
22. Diel J, Ortiz O, Losada RA, Price DB, Hayt MW, Katz DS, et al.The sacrum: Pathologic spectrum, multimodality imaging, and subspecialty approach. Radiographics 2001;21:83-104.
23. Smith J, Wixon D, Watson RC. Giant-cell tumor of the sacrum. Clinical and radiologic features in 13 patients. J Can Assoc Radiol 1979;30:34-9.
24. Kwon JW, Chung HW, Cho EY, Hong SH, Choi SH, Yoon YC, et al. MRI findings of giant cell tumors of the spine. AJR Am J Roentgenol 2007;189:246-50.
25. Anchan C. Giant cell tumor of bone with secondary aneurysmal bone cyst. Int J Shoulder Surg 2008;2:68.
26. Kransdorf MJ, Sweet DE. Aneurysmal bone cyst: Concept, controversy, clinical presentation, and imaging. AJR Am J Roentgenol 1995;164:573-80.
27. Murphey MD, Flemming DJ, Torop AH, Smith SE, Sonin AH, Temple HT. Imaging differentiation of primary and secondary aneurysmal bone cyst with pathologic correlation (abstr). Radiology 1998;209:311.
28. Libicher M, Bernd L, Schenk JP, Mädler U, Grenacher L, Kauffmann GW, et al. Characteristic perfusion pattern of osseous giant cell tumor in dynamic contrast-enhanced MRI. Radiologe 2001;41:577-82.
29. O’Connor W, Quintana M, Smith S, Willis M, Renner J. The hypermetabolic giant: 18F-FDG avid giant cell tumor identified on PET-CT. J Radiol Case Rep 2014;8:27-38.
30. Costelloe CM, Chuang HH, Madewell JE. FDG PET/CT of primary bone tumors. AJR Am J Roentgenol 2014;202:W521-31.
31. Tian R, Su M, Tian Y, Li F, Li L, Kuang A, et al.Dual-time point PET/CT with F-18 FDG for the differentiation of malignant and benign bone lesions. Skeletal Radiol 2009;38:451-8.
32. Salzer-Kuntschik M. Differential diagnosis of giant cell tumor of bone. Verh Dtsch Ges Pathol 1998;82:154-9.
33. Nedopil A, Raab P, Rudert M. Desmoplastic fibroma: A case report with three years of clinical and radiographic observation and review of the literature. Open Orthop J 2013;8:40-6.
34. Gong YB, Qu LM, Qi X, Liu JG. Desmoplastic fibroma in the proximal femur: A case report with long-term follow-up. Oncol Lett 2015;10:2465-7.
35. Pavlovic S, Valyi-Nagy T, Profirovic J, David O. Fine-needle aspiration of brown tumor of bone: Cytologic features with radiologic and histologic correlation. Diagn Cytopathol 2009;37:136-9.
36. Liu PT, Valadez SD, Chivers FS, Roberts CC, Beauchamp CP. Anatomically based guidelines for core needle biopsy of bone tumors: Implications for limb-sparing surgery. Radiographics 2007;27:189-205.
37. O’Donnell RJ, Springfield DS, Motwani HK, Ready JE, Gebhardt MC, Mankin HJ, et al. Recurrence of giant-cell tumors of the long bones after curettage and packing with cement. J Bone Joint Surg Am 1994;76:1827-33.
38. Lee FY, Montgomery M, Hazan EJ, Keel SB, Mankin HJ, Kattapuram S, et al. Recurrent giant-cell tumor presenting as a soft-tissue mass. A report of four cases. J Bone Joint Surg Am 1999;81:703-7.
39. Remedios D, Saifuddin A, Pringle J. Radiological and clinical recurrence of giant-cell tumour of bone after the use of cement. J Bone Joint Surg Br 1997;79:26-30.
40. 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 Oncol 2010;11:275-80.
41. Hakozaki M, Tajino T, Yamada H, Hasegawa O, Tasaki K, Watanabe K, et al.Radiological and pathological characteristics of giant cell tumor of bone treated with denosumab. Diagn Pathol 2014;9:111.
42. Unni KK. Dahlin’s Bone Tumors: General Aspects and Data on 11,087 Cases. 5th ed. Philadelphia, PA: Lippincott-Raven; 1996.

How to Cite this article:  Pilania K, Jankharia B. Current Concepts in Imaging of Giant Cell Tumor of Bone. Journal of Bone and Soft Tissue Tumors May-Aug 2017;3(1): 2-6.

 

 (Abstract    Full Text HTML)      (Download PDF)

Intralesional Curettage technique for Giant cell tumor of bone – current concepts and evidence

Volume 3 | Issue 1 | May- Aug 2017 | Page 7-12 | Manish Agarwal

Authors: Manish Agarwal [1]

[1]Department of Surgical Oncology, P.D Hinduja Hospital & Medical Research Centre, Veer SavarkarMarg, Mahim, Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Manish Agarwal,
P.D Hinduja Hospital & Medical Research Centre,
Veer SavarkarMarg, Mahim, Mumbai – 400 016, Maharashtra, India.
E-mail: mgagarwal@gmail.com

Abstract

Intralesionalsurgery is the most favored kind of surgery for giant-cell tumors of the bone. A good surgical technique helps minimize the risk of local recurrence. A good exposure followed by meticulous curetting aided by a high-speed burr is the backbone of this surgery. The role of chemical and thermal adjuvants is discussed with the evidence. The best way to reconstruct the cavity after curettage has been hotly debated. This article discusses the role of bone, cement, as well as a combination “sandwich” technique.
Keywords: Intralesional surgery, curettage, giant-cell tumor, adjuvant, “sandwich” reconstruction.

References

1. Bini SA, Gill K, Johnston JO. Giant cell tumor of bone. Curettage and cement reconstruction. Clin Orthop Relat Res. 1995 Dec (321):245–50.
2. Malawer MM, Dunham W. Cryosurgery and acrylic cementation as surgical adjuncts in the treatment of aggressive (benign) bone tumors. Analysis of 25 patients below the age of 21. Clin Orthop Relat Res [Internet]. 1991 Jan ;(262):42–57.
3. Blackley HR, Wunder JS, Davis a M, 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):811–20.
4. Goldenberg RR, Campbell CJ, Bonfiglio M. Giant-cell tumor of bone. An analysis of two hundred and eighteen cases. J Bone Joint Surg Am [Internet]. 1970 Jun [cited 2016 Apr 10];52(4):619–64. Available from: http://www.ncbi.nlm.nih.gov/pubmed/5479455
5. Ward WG, Li G. Customized Treatment Algorithm for Giant Cell Tumor of Bone : 2002;(397):259–70.
6. Nicholson NC, Ramp WK, Kneisl JS, Kaysinger KK. Hydrogen peroxide inhibits giant cell tumor and osteoblast metabolism in vitro. Clin Orthop Relat Res. 1998;1998(347):250–60.
7. Salai M, Rahamimov N. Prevention of recurrent giant-cell tumors of long bones a new surgical technique. J Surg Oncol. 1999;72(1):37–8.
8. Turcotte RE, Wunder JS, Isler MH, Bell RS, Schachar N, Masri B a, et al. Giant cell tumor of long bone: a Canadian Sarcoma Group study. Clin Orthop Relat Res. 2002;(397):248–58.
9. Marcove RC, Weis LD, Vaghaiwalla MR, Pearson R, And MD~, Huvos AG. Cryosurgery in the treatment of giant cell tumors of bone. A Report of 52 Consecutive Cases. Cancer 41:957-969, 1978
10. Bickels J, Kollender Y, Merimsky O, Isaakov J, Petyan-Brand R, Meller I. Closed argon-based cryoablation of bone tumours. J Bone Jt Surg [Internet]. 2004;86(5):714–8. Available from: http://www.bjj.boneandjoint.org.uk/cgi/doi/10.1302/0301-620X.86B5.14416
11. Meller I, Weinbroum A, Bickels J, Dadia S, Nirkin A, Merimsky O, et al. Fifteen years of bone tumor cryosurgery: A single-center experience of 440 procedures and long-term follow-up. Eur J Surg Oncol. 2008;34(8):921–7.
12. Malawer MM, Bickels J, Meller I, Buch RG, Henshaw RM, Kollender Y. Cryosurgery in the treatment of giant cell tumor. A long-term followup study. Clin Orthop Relat Res. 1999;1999(359):176–88.
13. Veth R, Schreuder B, van Beem H, Pruszczynski M, de Rooy J. Cryosurgery in aggressive, benign, and low-grade malignant bone tumours. Lancet Oncol. 2005;6(1):25–34.
14. Quint U, Vanhöfer U, Harstrick a, Müller RT. Cytotoxicity of phenol to musculoskeletal tumours. J Bone Joint Surg Br. 1996;78(6):984–5.
15. Quint U, Müller RT, G M. Characteristics of phenol. Instillation in intralesional tumor excision of chondroblastoma, osteoclastoma and enchondroma. Arch Orthop Trauma Surg. 1998;117(1–2):43–6.
16. Toy PC, Heck RK.. General Principles of tumors. In: Campbells operative orthopaedics. 2012. Ch. 24. Canale ST, Beaty JH, editors. St. Louis: Elsevier Health Sciences; 2012.
17. Nithyananth M, Priscilla AJ, Boopalan P, Titus V, Lee VN. Time required for effective action of phenol against giant cell tumour cells. J Orthop Surg. 2014;22(1):104–7.
18. Schiller C, Ritschl P, Windhager R, Kropej D, Kotz R. [The incidence of recurrence in phenol treated and non-phenol treated bone cavities following intralesional resection of non-malignant bone tumors]. Z Orthop Ihre Grenzgeb [Internet]. [cited 2016 Aug 1];127(4):398–401. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2815940
19. Lackman RD, Hosalkar HS, Ogilvie CM, Torbert JT, Fox EJ. Intralesional curettage for grades II and III giant cell tumors of bone. Clin Orthop Relat Res. 2005;438(438):123–7.
20. Agency for Toxic Substances and Disease Registry (ATSDR). Toxicological Profile for Phenol (Update). 2008.
21. Teixeira LEM, Miranda RH, Druda OL, Azevedo Neto JG, Rajão GDS. Isolated cauterization as an adjuvant in the treatment of benign bone tumors. Acta Ortop Bras. [online]. 2011; 19(4):198-201. Available from URL: http://www.scielo.br/aob.
22. Saiz P, Virkus W, Piasecki P, Templeton A, Shott S, Gitelis S. Results of giant cell tumor of bone treated with intralesional excision. Clin Orthop Relat Res. 2004;(424):221–6.
23. Dominkus M, Sabeti M, Toma C, Abdolvahab F, Trieb K, Kotz RI. Reconstructing the extensor apparatus with a new polyester ligament. Clin Orthop Relat Res [Internet]. 2006;453(453):328–34. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16936591
24. 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 Clin Oncol. 2008;134(9):969–78.
25. Lewis VO, Wei A, Mendoza T, Primus F, Peabody T, Simon M a. Argon beam coagulation as an adjuvant for local control of giant cell tumor. Clin Orthop Relat Res. 2007;454(454):192–7.
26. Ofluoglu O. Aggressive treatment of giant cell tumour with multiple local adjuvants. Acta Orthop Belg. 2008;74:831–6.
27. Benevenia J, Patterson FR, Beebe KS, Abdelshahed MM, Uglialoro AD. Comparison of phenol and argon beam coagulation as adjuvant therapies in the treatment of stage 2 and 3 benign-aggressive bone tumors. Orthopedics [Internet]. 2012;35(3):e371-8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22385449
28. Algawahmed H, Turcotte R, Farrokhyar F, Ghert M. High-Speed Burring with and without the Use of Surgical Adjuvants in the Intralesional Management of Giant Cell Tumor of Bone: A Systematic Review and Meta-Analysis. Hindawi Publishing Corporation Sarcoma; 2010;586090(5).
29. Frassica FJ, Gorski JP, Pritchard DJ, Sim FH, Chao EY. A comparative analysis of subchondral replacement with polymethylmethacrylate or autogenous bone grafts in dogs [Internet]. Clin Orthop Relat Res. 1993. p. 378–90. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8339507
30. Von Steyern F V., Kristiansson I, Jonsson K, Mannfolk P, Heinegard D, Rydholm A. Giant-cell tumour of the knee: The condition of the cartilage after treatment by curettage and cementing. J Bone Jt Surg – Br Vol . 2007;89–B(3):361–5.
31. Tejwani SG, Hame SL, Eckardt JJ. Subchondral giant-cell tumor of the proximal tibia: Arthroscopic treatment for accelerated articular cartilage and meniscal degeneration in two patients. Arthrosc – J Arthrosc Relat Surg. 2004;20(6):644–9.
32. Chen TH, Su YP, Chen WM. Giant cell tumors of the knee: Subchondral bone integrity affects the outcome. Int Orthop. 2005;29(1):30–4.
33. Buecker PJ, Gebhardt MC. Are Fibula Strut Allografts a Reliable Alternative for Periarticular Reconstruction after Curettage for Bone Tumors? Clin Orthop Relat Res [Internet]. 2007;461(Aug):170–4.

How to Cite this article:  Agarwal M. Intralesional Curettage Technique for Giant-cell Tumor of Bone – Current Concepts and Evidence. Journal of Bone and Soft Tissue Tumors May-Aug 2017;3(1): 7-12.

  (Abstract    Full Text HTML)      (Download PDF)