Giant Cell Tumor Case Study

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Metachronous Multicentric Giant cell tumor: a case report ABSTRACT Multicentric giant cell tumors represent less than 1% of all giant cell tumors of bones. We report a case of young girl with metachronous multicentric giant cell tumors with 5 documented lesions in a monomelic lower limb. The initial lesion started during the first trimester of her pregnancy around her right pelvis and resulted in rapidly progressive painful swelling with restricted mobility of her right hip joint. These tumors had typical radiological appearance and the diagnosis of giant cell tumor was confirmed on histopathology. She was managed by an aggressive surgical approach for knee and talar lesions, whereas repeated embolization was done to treat her pelvic lesion.…show more content…
Due to invasiveness and the large size of the pelvic tumour, we decided to do repeated selective embolization of the pelvic tumour, as it was considered inoperable tumour in its present stage. This highly vascular tumour was supplied by the branches of right internal iliac, external iliac and femoral arteries. Embolization was done with gelfoam slurry and pledgets. 4 sittings of embolization were done at 3 weekly intervals. These resulted in significant reduction in pain score (1/10) and swelling of this lesion. Right patellectomy with repair of quadriceps and patellar tendon was done for the patellar lesion. The involved patella was egg shell like in consistency and had ballooned out due to expansile nature of the lesion, but the articular surface of it was found intact, at surgery. She also underwent curettage and cementing of distal femoral lesion with prophylactic distal femoral locked plate fixation (Fig ) and curettage and autologous bone grafting for talar lesion. After 6 months of follow up with repeated embolisation the pelvic lesion started showing improvement and signs of calcification could easily be well appreciated on X-Rays (Fig ). At 1 year follow up, all the lesions were pain free and she could her activities of daily living with little…show more content…
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