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The Journal of Bone and Joint Surgery, Vol 69, Issue 1 106-114, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Giant-cell tumor of bone
M Campanacci, N Baldini, S Boriani and A Sudanese
Of 327 patients who had a giant-cell tumor of bone and were seen at the
Istituto Rizzoli, 293 were treated at the Institute, and 280 of these were
followed for two to forty-four years. The distribution according to sex and
age of the patient and site of the tumor was similar to the distributions
in major reports of large series. The tumor usually involved the metaphysis
and the epiphysis, but was occasionally limited to the metaphysis, and in
only 2 per cent of the patients was it adjacent to an open growth plate.
The tumor on occasion invaded the articular space, also involving the
ligaments and the synovial membrane. Extension to an adjacent bone through
the joint occurred in 5 per cent of the tumors. Our radiographic grading,
which is roughly comparable with the staging system of Enneking et al., was
Grade I in 4 per cent, II in 74 per cent, and III in 22 per cent of 266
patients before treatment. A pathological fracture was apparent on the
first radiograph in 9 per cent of the patients. In the 280 patients with
adequate follow-up, 331 surgical procedures were performed. The rate of
local recurrence was 27 per cent in the 151 intralesional procedures, 8 per
cent in the 122 marginal excisions, and zero in the fifty-eight wide or
radical procedures. These results did not correlate with the radiographic
grade of the lesion. Of the fifty-one local recurrences that were seen
after treatment at our institution, 90 per cent appeared in the first three
years after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
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