Giant cell tumor of distal femur with pathological fracture: A case report

Abstract

Giant cell tumors (GCT) are benign tumors with potential for aggressive behaviour and capacity to metastasize. Although rarely lethal, benign bone tumors may be associated with a substantial disturbance of the local bony architecture that can be particularly troublesome in peri-articular locations. It is characterized by a proliferation of mononuclear stromal cells and the presence of many multi- nucleated giant cells with homogenous distribution.There is no widely held consensus regarding the ideal treatment method selection. There are advocates of varying surgical techniques ranging from intra-lesional curettage to wide resection. Although GCT is classified as a benign lesion, few patients develop progressive lung metastases with poor outcomes. Treatment is mainly surgical. Options of chemotherapy and radiotherapy are reserved for selected cases. A case of giant cell tumor of distal femur with pathological fracture is reported here. A 39 yr old male with h/o trivial trauma presented with swelling and tenderness over Left thigh and knee. A detailed work up was done and a GCT of distal femur (causing pathological fracture) was confirmed. Patient was managed with surgery in which Tumor excision, curettage and bone grafting was done, and the fracture fixed with locking compression plate. After 6 months of follow up, fracture was well united with no radiological sign of recurrence of tumor.