[Tumor-segmental resection of hand-foot-giant cell tumor of bone and autologous iliac bone graft reconstruction].

Abstract

OBJECTIVE:

To evaluate the effectiveness of tumor-segmental resection and autologous iliac bone graft reconstruction combined with internal fixation in treating hand-foot-giant cell tumor of bone.

METHODS:

Between August 1997 and April 2008, 8 cases of hand-foot-giant cell tumor of bone were treated, including 3 males and 5 females with an average age of 28.5 years (range, 16-42 years). The locations were metacarpal bones in 3 cases, metatarsal bones in 4 cases, and phalanges of toes in 1 case. According to Campanacci's gradation of X-ray films, there were 1 case of grade I and 7 cases of grade II; according to pathological examination before operation, there were 3 cases of grade I to II, 4 cases of grade II, and 1 case of grade II to III; and according to TNM staging, there were 1 case of TisN0M0, 4 cases of T1N0M0, and 3 cases of T2N0M0. There were 2 cases of recurrence, the time from the first operation to recurrence were 11 and 14 months, respectively. The tumor size was 1.8 cm x 1.0 cm to 6.0 cm x 2.0 cm, the cortical bone became thinner, and the boundary between tumor and periosteum was clear. All patients underwent tumor-segmental resection combined with autologous iliac bone graft reconstruction, and miniplate internal fixation by lumbar anesthesia or trachea cannula anesthesia.

RESULTS:

All incision healed by first intention. Eight patients were followed up 10 to 84 months with an average of 46 months. Radiographs showed that fracture union was achieved at 3 to 9 months (mean, 5 months). No significant rotation, angular, and shortening deformity occurred in iliac bone graft. The function of iliac bone donor site recovered excellently. The pathological examination showed giant cell tumor of bone in all cases, including 2 case of grade I-II, 5 cases of grade II, and 1 case of grade II-III. The hand or foot function recovered excellently. No tumor recurrence or lung metastasis occurred during follow-up.

CONCLUSION:

Tumor-segmental resection combined with autologous iliac bone graft reconstruction plus internal fixation has excellent effectiveness for hand-foot-giant cell tumor of bone.

• Authors: Jianhua Ge, Ge Chen, Zhongjie Zhang, Yongxian Wan, Xiaobo Lu
• Journal: Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery (Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi) Vol. 24 Issue 8 Pg. 922-5 (Aug 2010) ISSN: 1002-1892 [Print] China
• PMID: 20839436 (Publication Type: Evaluation Study, Journal Article)

Topics

• Adolescent
• Adult
• Bone Neoplasms (surgery)
• Bone Transplantation
• Female
• Giant Cell Tumors (surgery)
• Humans
• Ilium (transplantation)
• Male
• Metacarpal Bones (pathology)
• Metatarsal Bones (pathology)
• Toe Phalanges (pathology)
• Transplantation, Autologous
• Treatment Outcome
• Young Adult