J Korean Orthop Assoc.  2016 Oct;51(5):411-417. 10.4055/jkoa.2016.51.5.411.

The Clinical Characteristics of Giant Cell Tumor of Bone with Aneurysmal Bone Cyst

Affiliations
  • 1Department of Orthopaedic Surgery, Kosin University Gospel Hospital, Busan, Korea. shchung@kosin.ac.kr
  • 2Department of Radiology, Kosin University Gospel Hospital, Busan, Korea.
  • 3Department of Pathology, Kosin University Gospel Hospital, Busan, Korea.

Abstract

PURPOSE
The purpose of this study was to evaluate the difference in clinical features, process, and prognosis depending on the presence of secondary aneurysmal bone cysts (ABCs) in patients with giant cell tumors.
MATERIALS AND METHODS
A total of 33 patients who underwent surgery for giant cell bone tumors between March 2009 and April 2013 were selected. Data on clinical features were obtained from medical records and pathological and radiological review, including age, sex, location, and size of the tumor, and Campanacci grade, as well as whether there was any pathological fracture, local recurrence, distant metastasis, or malignant transformation. The Student t-test and Fisher exact test were used for comparison of the differences in clinical features by the presence or absence of ABCs.
RESULTS
Local recurrence occurred in 6 of the 33 cases, 3 each were in the groups with and without ABCs; however, the difference was not statistically significant. In total, nine cases had pathological fractures, seven were in the group with ABC and two were in the group without ABC (p=0.013). No statistically significant differences in age, sex, location and size of the tumor, or Campanacci grade were observed between the groups with and without ABCs.
CONCLUSION
There was no difference in the frequency of local recurrence between the groups with and without ABCs. However, pathological fracture occurred more frequently in the group with ABCs compared to the group without ABCs.

Keyword

giant cell tumors; aneurysmal bone cysts; pathological fracture; clinical characteristics

MeSH Terms

Bone Cysts, Aneurysmal
Fractures, Spontaneous
Giant Cell Tumor of Bone*
Giant Cell Tumors*
Giant Cells*
Humans
Medical Records
Neoplasm Metastasis
Prognosis
Recurrence

Figure

  • Figure 1 (A) Photomicrograph of curetted lesions shows the presence of osteoclast-like giant cells that appear scattered among numerous round or spindled-shaped mononuclear cells, representing conventional giant-cell tumor. (B) Multiple cyst-like spaces filled with blood represent secondary aneurysmal bone cyst complicating giant-cell tumor (A, B: H&E, ×200).

  • Figure 2 (A) Preoperative and postoperative radiographs of giant cell tumor of distal femur with pathological fracture. Wide excision and reconstruction with tumor prosthesis was done. (B) Magnetic resonance image of giant cell tumor of the distal femur with a pathological fracture and aneurysmal bone cyst, showing multiple septa and fluid-fluid level.


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