Giant Cell Tumor of The Proximal Phalanx of The Index Finger of The Hand: A Rare Case Report
Downloads
Background: Giant cell tumor (GCT) of bone is a relatively common type of benign tumor involving the epiphyseal region of tubular bones, but GCT rarely occurs at hand (1–4% of all GCT). GCT within the hand tends to be more aggressive and recurs more rapidly in hand than in other locations. Most authors prefer curettage or resection with reconstruction to maintain anatomical and functional integrity.
Case Report: A 27-year-old man with a chief complaint of an enlarged lump and pain in the index finger of his left hand. These lumps appeared three months ago. Plain radiographs showed lytic, eccentric, geographic lesions with well-defined borders and narrow transition zones. Magnetic resonance imaging (MRI) showed a primary aggressive bone tumor with extension to the surrounding soft tissue. Fine Needle Aspiration Biopsy (FNAB) revealed the lesion as a Bone Giant Cell Tumor. The patient then underwent local resection and reconstruction using an allograft. Range of movement (ROM) measurements and DASH scores were evaluated.
Discussion: Radiographic and MRI examinations showed characteristic cortical breach, and FNAB showed multinucleated giant cell spread. After treatment, the patient was found to be pain-free, have an improved ROM, and reduced disability. There was no recurrence observed.
Conclusion: Despite the tendency for hand GCT to be more aggressive, local resection and reconstruction using an allograft with adjuvant hydrogen peroxide can reduce recurrence and disability.
Barnaba A, Colas M, Larousserie F, Babinet A, Anract P, Biau D. Burden of complications after giant cell tumor surgery. A single-center retrospective study of 192 cases. Orthop Traumatol Surg Res. 2022; 108: 430–7.
Lipplaa A, Dijkstra S, Gelderblom H. Challenges of denosumab in giant cell tumor of bone, and other giant cell-rich tumors of bone. Curr Opin Oncol. 2019; 31: 329–35.
Konishi E, Outani H, Mano M, Nagata S, Shirai T, Naka N, et al. Giant cell tumor of bone – Analysis of 213 cases involving extra-craniofacial bones. Pathol Int. 2021; 71(8): 500–11.
Ambrosi F, Righi A, Benini S, Magagnoli G, Chiaramonte I, Manfrini M, et al. Giant cell tumor of bone in patients under 16 years old: A single-institution case series. Cancers (Basel). 2021;13(11):2585.
Palmerini E, Picci P, Reichardt P, Downey G. Malignancy in giant cell tumor of vone: A review of the literature. Technol Cancer Res Treat. 2019;18:1533033819840000.
Latorre MR, Albergo JI, Farfalli GL, Roitman PD, Plantalech L, Ayerza MA, et al. Denosumab as a neoadjuvant treatment for giant cell tumor of bone. Indications, results and side effects. Medicina (B Aires).2021;81:767–73.
Fletcher CDM, Bridge KA, Bridge KA, Hogendoom PCW, Mertens F, editors. WHO classification of tumours of soft tissue and bone. Lyon: IARC Press; 2013.
Verschoor AJ, Bovée JVMG, Mastboom MJL, Djikstra PDS, De Sande MAJV, Gelderblom H. Incidence and demographics of giant cell tumor of bone in The Netherlands: first nationwide pathology registry study. Acta Orthop. 2018;89(5):570–4.
Sobti A, Agrawal P, Agarwala S, Agarwal M. Giant cell tumor of bone - an overview. Arch bone Jt Surg. 2016;4(1):2–9.
Adulkasem N and Pruksasorn D. Giant cell tumour of the middle phalanx of the middle finger. BMJ Case Rep. 2019;12(3):e229076.
Bertoni F, Present D, Sudanese A, Baldini M, Bacchini P, Campanacci M. Giant-cell tumor of bone with pulmonary metastases: Six case reports and a review of the literature. Clin Orthop Relat Res. 1988;237:275–85.
Mallick BA and Chawla SP. Giant cell tumor of bone: an update. Curr Oncol Rep. 2021;23(5):51.
Kalil RK and Amary F. Giant Cell Tumor of Bone. In: Santini-Araujo E, Kalil RK, Bertoni F, Park YK, editors. Tumors and Tumor-Like Lesions of Bone. Cham: Springer International Publishing; 2020. p. 381–97.
Cleven A and Bovee J. Bone: Giant cell tumour of bone. Atlas Genet Cytogenet Oncol Haematol. 2018;22.
Shi M, Chen L, Wang Y, Wang W, Zhang Y, Yan S. Effect of bisphosphonates on local recurrence of giant cell tumor of bone: a meta-analysis. Cancer Manag Res. 2019;11:669-80.
Raskin KA, Schwab JH, Mankin HJ, Springfield DS, Hornicek FJ. Giant Cell Tumor of Bone. J Am Acad Orthop Surg. 2013;21(2):118–26.
De Vita A, Vanni S, Miserocchi G, Fausti V, Pieri F, Spadazzi C, et al. A rationale for the activity of bone target therapy and tyrosine kinase inhibitor combination in giant cell tumor of bone and desmoplastic fibroma: translational evidences. Biomedicines. 2022;10(2):372.
López-Pousa A, Broto JM, Garrido T, Vazquez J. Giant cell tumour of bone: new treatments in development. Clin Transl Oncol. 2015;17(6):419–30.
Gortzak Y, Kandel R, Deheshi B, Werier J, Turcotte RE, Ferguson PC, et al. The efficacy of chemical adjuvants on giantcell tumour of bone: An in vitro study. J Bone Jt Surg. 2010;92(10):1475-9.
Benevenia J, Rivero SM, Moore J, Ippolito J, Siegerman D, Beebe K, et al. Supplemental bone grafting in giant cell tumor of the extremity reduces nononcologic complications. Clin Orthop Relat Res. 2017;475(3):776-83.
Copyright (c) 2022 Journal Orthopaedi and Traumatology Surabaya (JOINTS)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
- The author acknowledges that the copyright of the article is transferred to the Journal of Orthopaedi and Traumatology Surabaya (JOINTS), whilst the author retains the moral right to the publication.
- The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution-Non Commercial-Share Alike 4.0 International License (CC BY-NC-SA).
- All published manuscripts, whether in print or electronic form, are open access for educational, research, library purposes, and non-commercial uses. In addition to the aims mentioned above, the editorial board is not liable for any potential violations of copyright laws.
- The form to submit the manuscript's authenticity and copyright statement can be downloaded here.
Journal of Orthopaedi and Traumatology Surabaya (JOINTS) is licensed under a Creative Commons Attribution-Non Commercial-Share Alike 4.0 International License.