Clinico radiological Presentation and Management of Giant Cell Tumour of Calcaneum: A Case Report

Abstract

Giant cell tumours of bone are typically benign tumours composed of mononuclear and multinucleated giant cells that are osteoclastically active. They typically develop in long bones but can also appear in unexpected locations. In this case report, a 36-year-old man presented to the orthopaedic OPD with complaints of right heel pain and swelling. The swelling was firm, painful, and adhered to the calcaneus. Radiographs revealed a well-defined, expansile, lytic lesion of the calcaneus with no extraosseous dissemination. After surgery, tissue was sent for histopathological examination, which showed multinucleated giant cells amid numerous mononuclear stromal cells, raising the possibility of a giant cell tumour. During anaesthesia, the bony recess was corrected and filled with bone cement. Patient was ambulatory after three months of the procedure and showed no clinical and radiographic evidence of recurrence even after two years of follow up. Aggressive characteristics of giant cell tumours can include cortical growth or destruction with a soft tissue component. In certain instances, fluid-filled levels suggestive of subsequent aneurysmal bone cyst development are also visible. Since there are no clinical, radiological, or histological factors that allow one to precisely anticipate the trend of a single lesion to recur or to metastasize, treating bone giant cell tumours remains difficult. Therefore, the surgeon must be well-informed and complete a thorough preoperative work up, including a biopsy, before moving forward with the lesion’s final therapy. Early intervention is required due to its potential local aggression. Regular follow-up with the patient is necessary to spot any early signs of metastasis or recurrence.