Case Report
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NONTRAUMATIC ANKLE PAIN IN ADOLESCENT : A CASE OF GIANT CELL TUMOR.

Year 2015, Volume: 7 Issue: 1, 140 - 146, 22.03.2015

Abstract

Introduction : Giant cell tumor is generally occurs in long bones and adults . It is rarerly seen at the ankle of children.
Case Presentation: A 16 years old boy presented with a painful ankle. We diagnosed a giant cell tumor at right ankle. The giant cell tumor of distal tibia was treated with an intralesional curettage, phenol application , bioseramic graft and bone plate fixation. There are no recurrance and methastasis of tumor at the followup. Patient is walking without pain and he has not any complaint.
Conclusions : Giant cell tumor of the bone is local aggressive tumor and aproxi-mately seen 5 % of all primary bone tumor. Treatment choise is including intrale-sional curttage and resection of tumor. Adjuvant therapy is a debate. Phenol, alcohol and bone cement are commonly used in adjuvant therapy. Cement, bone graft and bioseramic graft are using after curettage to fill cavity. There are not a satisfactory standart treatment method. We treat and document a safe treatment method of giant cell tumor with an intralesional curattage , phenol therapy and bioseramic grafting in skeletally immatur patient.

References

  • 1-Heck RK,Jr. Benign (Occasionally Aggressive) Tumors of Bone. In; Canale ST. Campbell’s Operative Orthopaedics . 11th ed. Memphis, Tennessee; 2011:883-886.
  • 2- Klenke FM, Wenger DE, Inwards CY, Rose PS, Sim FH. Giant cell tumor of bone: risk factors for recurrence. Clin Orthop Relat Res. 2011 ;469:591-9.
  • 3- Vanni D, Pantalone A, Andreoli E, Caldora P, Salini V.Giant cell tumor of the distal ulna: a case report. J Med Case Rep. 2012;6:143.
  • 4- Economopoulos K, Barker L, Beauchamp C, Claridge R.Case report: reconstruction of the distal tibia with porous tantalum spacer after resection for giant cell tumor. Clin Orthop Relat Res. 2010 ;468:1697-701.
  • 5- Balke M, Schremper L, Gebert C, Ahrens H, Streitbuerger A, Koehler G, Hardes J, Gosheger G. Giant cell tumor of bone: treatment and outcome of 214 cases. J Cancer Res Clin Oncol. 2008;134:969-78.
  • 6- Puri A, Agarwal M. Treatment of giant cell tumor of bone: Current concepts. Indian J Orthop. 2007;41:101-8.
  • 7- Yücetürk G, Sabah D, Keçeci B, Kara AD, Yalçinkaya S. Prevalence of bone and soft tissue tumors. Acta Orthop Traumatol Turc. 2011; 45: 135-43.
  • 8- Jung ST, Park HW, Lee KB, Lee DH, Choi JI. Multicentric giant cell tumor in adolescents: three case reports.J Pediatr Orthop B. 2012 : 24.
  • 9- Campanacci M, Baldini N, Boriani S, Sudanese A. Giant-cell tumor of bone. J Bone Joint Surg Am. 1987;69:106–114
  • 10- Heck RK,Jr, Peter G. General Principles of Tumors. In; Canale ST. Campbell’s Operative Orthopaedics . 11th ed. Memphis, Tennessee; 2011:775-781.
  • 11- Lin WH, Lan TY, Chen CY, Wu K, Yang RS. Similar local control between phenol and ethanol treated giant cell tumors of bone. Clin Ort-hop Relat Res. 2011;469:3200-8.
  • 12- van der Heijden L, van de Sande MA, Dijkstra PD.Soft tissue extension increases the risk of local recurrence after curettage with adjuvants for giant-cell tumor of the long bones. Acta Orthop. 2012; 83:401-5.
  • 13- Schindler OS, Cannon SR, Briggs TW, Blunn GW. Composite ceramic bone graft substitute in thetreat-ment of locally aggressive benign bone tumours. J Orthop Surg (Hong Kong). 2008;16:66-74.
  • 14- Morii T, Yabe H, Morioka H, Suzuki Y, Anazawa U, Toyama Y.Curettage and allograft reconstruction for giant cell tumours. J Orthop Surg (Hong Kong). 2008;16:75-9.
  • 15- Fraquet N, Faizon G, Rosset P, Phillipeau JM, Waast D, Gouin F. Long bones giant cell tumors: treatment by curretage and cavity filling cementation. Orthop Traumatol Surg Res. 2009;95:402-6.
  • 16- Hattori H, Matsuoka H, Yamamoto K. Radiological and histological analysis of synthetic bone grafts in recurring giant cell tumour of bone: a retrospective study. J OrthopSurg (Hong Kong). 2010;18:63-7.
  • 17- Feigenberg SJ, Marcus RB, Jr, Zlo-tecki RA, Scarborough MT, Berrey BH, Enneking WF. Radiation therapy for giant cell tumors of bone. Clin Orthop Relat Res. 2003; 411:207–16.

NONTRAVMATİK AYAK BİLEĞİ AĞRILI ADOLESANDA DEV HÜCRELİ TÜMÖR OLGUSU

Year 2015, Volume: 7 Issue: 1, 140 - 146, 22.03.2015

Abstract

Giriş: Dev hücreli tümör uzun kemiklerde görülmekle beraber iskelet gelişimi tamamlanmamış kişilerde ve ayak bileği çevresinde görülmesi nadirdir.
Olgu Sunumu: 16 yaşında ayak bileği ağrısı ile başvuran bir çocuk hastada yapılan tetkiklerde dev hücreli tümör saptadık. Tümör küretaj, fenol tedavisi, bioseramik greftleme ve plak vida fiksasyonu ile tedavi edildi. Hasta takibinde ağrısız bir şekilde yürüyordu. Rekürrens ve metastaz saptanmadı.

Tartışma ve Sonuç: Kemiğin dev hücreli tümörü %5 oranında görülebilen lokal agresif bir tümördür. Tedavide küretaj veya rezeksiyon yapılmaktadır. Adjuvan tedavide fenol, alkol, ve kemik çimentosu kullanılmaktadır. Bununla beraber adjuvan tedavi tartışmalıdır. Küretaj sonrası pmma, kemik grefti, sentetik kemik grefti veya bioseramik kullanılmaktadır. Standart bir tedavi yöntemi yoktur. İskelet gelişimini tamamlamamış hastada dev hücreli tümör küretaj, fenol ile adjuvan tedavi ve biose-ramik greftleme ile güvenli bir şekilde tedavi edilebildiğini gösterdik.

Dr. İzzet KORKMAZ
Dr. Özgür ÇİÇEKLİ
Dr. Nurdan KORKMAZ
Dr. Turgut AKGÜL

References

  • 1-Heck RK,Jr. Benign (Occasionally Aggressive) Tumors of Bone. In; Canale ST. Campbell’s Operative Orthopaedics . 11th ed. Memphis, Tennessee; 2011:883-886.
  • 2- Klenke FM, Wenger DE, Inwards CY, Rose PS, Sim FH. Giant cell tumor of bone: risk factors for recurrence. Clin Orthop Relat Res. 2011 ;469:591-9.
  • 3- Vanni D, Pantalone A, Andreoli E, Caldora P, Salini V.Giant cell tumor of the distal ulna: a case report. J Med Case Rep. 2012;6:143.
  • 4- Economopoulos K, Barker L, Beauchamp C, Claridge R.Case report: reconstruction of the distal tibia with porous tantalum spacer after resection for giant cell tumor. Clin Orthop Relat Res. 2010 ;468:1697-701.
  • 5- Balke M, Schremper L, Gebert C, Ahrens H, Streitbuerger A, Koehler G, Hardes J, Gosheger G. Giant cell tumor of bone: treatment and outcome of 214 cases. J Cancer Res Clin Oncol. 2008;134:969-78.
  • 6- Puri A, Agarwal M. Treatment of giant cell tumor of bone: Current concepts. Indian J Orthop. 2007;41:101-8.
  • 7- Yücetürk G, Sabah D, Keçeci B, Kara AD, Yalçinkaya S. Prevalence of bone and soft tissue tumors. Acta Orthop Traumatol Turc. 2011; 45: 135-43.
  • 8- Jung ST, Park HW, Lee KB, Lee DH, Choi JI. Multicentric giant cell tumor in adolescents: three case reports.J Pediatr Orthop B. 2012 : 24.
  • 9- Campanacci M, Baldini N, Boriani S, Sudanese A. Giant-cell tumor of bone. J Bone Joint Surg Am. 1987;69:106–114
  • 10- Heck RK,Jr, Peter G. General Principles of Tumors. In; Canale ST. Campbell’s Operative Orthopaedics . 11th ed. Memphis, Tennessee; 2011:775-781.
  • 11- Lin WH, Lan TY, Chen CY, Wu K, Yang RS. Similar local control between phenol and ethanol treated giant cell tumors of bone. Clin Ort-hop Relat Res. 2011;469:3200-8.
  • 12- van der Heijden L, van de Sande MA, Dijkstra PD.Soft tissue extension increases the risk of local recurrence after curettage with adjuvants for giant-cell tumor of the long bones. Acta Orthop. 2012; 83:401-5.
  • 13- Schindler OS, Cannon SR, Briggs TW, Blunn GW. Composite ceramic bone graft substitute in thetreat-ment of locally aggressive benign bone tumours. J Orthop Surg (Hong Kong). 2008;16:66-74.
  • 14- Morii T, Yabe H, Morioka H, Suzuki Y, Anazawa U, Toyama Y.Curettage and allograft reconstruction for giant cell tumours. J Orthop Surg (Hong Kong). 2008;16:75-9.
  • 15- Fraquet N, Faizon G, Rosset P, Phillipeau JM, Waast D, Gouin F. Long bones giant cell tumors: treatment by curretage and cavity filling cementation. Orthop Traumatol Surg Res. 2009;95:402-6.
  • 16- Hattori H, Matsuoka H, Yamamoto K. Radiological and histological analysis of synthetic bone grafts in recurring giant cell tumour of bone: a retrospective study. J OrthopSurg (Hong Kong). 2010;18:63-7.
  • 17- Feigenberg SJ, Marcus RB, Jr, Zlo-tecki RA, Scarborough MT, Berrey BH, Enneking WF. Radiation therapy for giant cell tumors of bone. Clin Orthop Relat Res. 2003; 411:207–16.
There are 17 citations in total.

Details

Primary Language Turkish
Subjects Orthopaedics
Journal Section Reviews
Authors

İzzet Korkmaz

Publication Date March 22, 2015
Published in Issue Year 2015 Volume: 7 Issue: 1

Cite

APA Korkmaz, İ. (2015). NONTRAVMATİK AYAK BİLEĞİ AĞRILI ADOLESANDA DEV HÜCRELİ TÜMÖR OLGUSU. Turkish Medical Journal, 7(1), 140-146.

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