BACKGROUND: Giant cell tumour (GCT) of bone is generally a benign tumour composed of mononuclear stromal cells and characteristic multinucleated giant cells that exhibit osteoclastic activity. It usually develops in long bones but can occur in unusual locations. The typical appearance is a lytic lesion with a well-defined but non-sclerotic margin that is eccentric in location, extends near the articular surface, and occurs in patients with closed physes. OBJECTIVE: The current study was planned to summarise our experiences with GCTB, and to evaluate individual effect of bone cement, high-speed burring and hydrogen per oxide (H2O2) on local recurrence. GCT can mimic or be mimicked by other benign or malignant lesions at both radiological evaluation and histological analysis. In the past, the mainstay of treatment was surgical, primarily consisting of curettage with cement placement, with recurrence rates of 15%-25%. Recurrence is suggested by development of progressive lucency at the cement-bone interface. RESULTS: Of the 21 patients who started the study, 4(19%) were lost to follow-up, and 17(81%) represented the final study sample. Of them, 16(94.11%) patients underwent the curettage procedure with adjuvant therapy and reconstruction with bone grafts taken from iliac crest. In 3(26.3%) patients, no adjuvant was used. Total of 6 (42.1%) patients had local recurrence and 3(50%) of them were those who were treated without any adjuvant; 2(33.3%) with phenol and 1(16.6%) with PMMA. CONCLUSIONS: The results of the present study suggest that an "aggressive curettage" with the use of adjuvant reduces the recurrence rate in a disease whose aggressiveness is not easy to predict.
BACKGROUND:Giant cell tumour (GCT) of bone is generally a benign tumour composed of mononuclear stromal cells and characteristic multinucleated giant cells that exhibit osteoclastic activity. It usually develops in long bones but can occur in unusual locations. The typical appearance is a lytic lesion with a well-defined but non-sclerotic margin that is eccentric in location, extends near the articular surface, and occurs in patients with closed physes. OBJECTIVE: The current study was planned to summarise our experiences with GCTB, and to evaluate individual effect of bone cement, high-speed burring and hydrogen per oxide (H2O2) on local recurrence. GCT can mimic or be mimicked by other benign or malignant lesions at both radiological evaluation and histological analysis. In the past, the mainstay of treatment was surgical, primarily consisting of curettage with cement placement, with recurrence rates of 15%-25%. Recurrence is suggested by development of progressive lucency at the cement-bone interface. RESULTS: Of the 21 patients who started the study, 4(19%) were lost to follow-up, and 17(81%) represented the final study sample. Of them, 16(94.11%) patients underwent the curettage procedure with adjuvant therapy and reconstruction with bone grafts taken from iliac crest. In 3(26.3%) patients, no adjuvant was used. Total of 6 (42.1%) patients had local recurrence and 3(50%) of them were those who were treated without any adjuvant; 2(33.3%) with phenol and 1(16.6%) with PMMA. CONCLUSIONS: The results of the present study suggest that an "aggressive curettage" with the use of adjuvant reduces the recurrence rate in a disease whose aggressiveness is not easy to predict.