CASE REPORT: Iatrogenic Seeding of a Giant Cell Tumor of the Patella to the Proximal Tibia

Ofluoğlu, Önder; Donthineni, Rakesh

doi:10.1097/blo.0b013e31813ffbd8

Cited by 18 publications

(14 citation statements)

References 18 publications

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“…6 Tumour recurrence at the bone graft donor site is rare but several cases of osteosarcoma, giant cell tumour and histiocytoma have been reported. [11][12][13][14][15][16] However, there has been no report about the metastasis of an odontogenic benign tumour to the bone graft site in the English literature. This report might be the first report about a metastasizing DGCT that was diagnosed at the distant donor site as well as the primary site.…”

Section: Discussionmentioning

confidence: 99%

“…Preferably, the choice of the bone harvest site should be more distant from the site of the tumour surgery, reducing the risk of any direct exposure of the donor area to the tumour tissue. 14 Dias et al 13 suggested that the tumour should be removed first and then the graft bone should be harvested to prevent haematogenous spreading of tumour seeds. Standard precautions and careful techniques are important for surgeons to avoid iatrogenic metastasis.…”

Section: Discussionmentioning

confidence: 99%

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Distant metastasis of intraosseous dentinogenic ghost cell tumour to the donor site of a bone graft

Hr¹,

Min²,

Kh³

et al. 2013

Dentomaxillofacial Radiology

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A dentinogenic ghost cell tumour (DGCT) is an extremely rare odontogenic tumour which is considered as a solid, neoplastic variant of calcifying odontogenic cyst. Intraosseous DGCTs are more aggressive than extraosseous DGCTs and have a high propensity for local recurrence. This report describes a case of a diagnosis of recurrent DGCT at the primary site and a distant donor site. A 25-year-old female patient visited a dental hospital for a complaint of facial swelling for the previous month. Incisional biopsy was performed and the specimen was diagnosed as DGCT. Partial mandibulectomy for tumour resection and iliac bone graft was performed. 2 years later, the tumour recurred on the mandible and iliac bone. The recurrent lesion on the donor site was diagnosed as metastasized DGCT. This report highlights the possibility of distant metastasis occurring at a graft donor site.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Distant metastasis of intraosseous dentinogenic ghost cell tumour to the donor site of a bone graft

Hr¹,

Min²,

Kh³

et al. 2013

Dentomaxillofacial Radiology

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“…A particular caution when using this technique (or any of the other techniques using harvesting autogenous graft) is the known risk of iatrogenic seeding of the bone graft donor site. The phenomenon of direct seeding of GCT is well known [13,17,32], and the surgeon and his or her entire team should accordingly pay special attention to preventing cross-contamination. In this study, a two-team approach using separate instruments was used to prevent cross-contamination; in addition to this, the bone graft was harvested from the contralateral iliac crest further separating the surgical fields.…”

Section: Discussionmentioning

confidence: 99%

Does Wrist Arthrodesis With Structural Iliac Crest Bone Graft After Wide Resection of Distal Radius Giant Cell Tumor Result in Satisfactory Function and Local Control?

Wang

Chan

Yang

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background Many techniques have been described for reconstruction after distal radius resection for giant cell tumor with none being clearly superior. The favored technique at our institution is total wrist fusion with autogenous nonvascularized structural iliac crest bone graft because it is structurally robust, avoids the complications associated with obtaining autologous fibula graft, and is useful in areas where bone banks are not available. However, the success of arthrodesis and the functional outcomes with this approach, to our knowledge, have only been limitedly reported. Questions/purposes (1) What is the success of union of these grafts and how long does it take? (2) How effective is the technique in achieving tumor control? (3) What complications occur with this type of arthrodesis? (4) What are the functional results of wrist arthrodesis by this technique for treating giant cell tumor of the distal radius? Methods Between 2005 and 2013, 48 patients were treated for biopsy-confirmed Campanacci Grade III giant cell tumor of the distal radius. Of those, 39 (81% [39 of 48]) were treated with wrist arthrodesis using autogenous nonvascularized iliac crest bone graft. Of those, 27 (69% [27 of 39]) were available for followup at a minimum of 24 months (mean, 45 months; range, 24-103 months). During that period, the general indications for this approach were Campanacci Grade III and estimated resection length of 8 cm or less. Followup included clinical and radiographic assessment and functional assessment using the Disabilities of the Arm, Shoulder and Hand (DASH) score, the Musculoskeletal Tumor Society (MSTS) score, grip strength, and range of motion at every followup by the treating surgeon and his team. All functional results were from the latest followup of each patient. Results Union of the distal junction occurred at a mean of 4 months (± 2 months) and union of the proximal junction occurred at a mean of 9 months (± 5 months). Accounting for competing events, at 12 months, the rate of proximal junction union was 56% (95% confidence interval [CI], 35%-72%), whereas it was 67% (95% CI, 45%-82%) at 18 months. In total, 11 of the 27 patients (41%) underwent repeat surgery on the distal radius, including eight patients (30%) who had complications and three (11%) who had local recurrence. The mean DASH score was 9 (± 7) (value range, 0-100, with lower scores representing better function), and the mean MSTS 1987 score was 29 (± 1) (value range, 0-30, with higher scores representing better function) as well as 96% (± 4%) of mean MSTS 1993 score (value range, 0%-100%, with higher scores representing

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“…Although tumor contamination is a rare complication, it has been reported in literature for different types of tumors. However, review of literature revealed only two cases of isolated implantation of GCT at bone graft harvest site 78…”

Section: Introductionmentioning

confidence: 99%

Iatrogenic giant cell tumor at bone graft harvesting site

Kundu

Gupta

Sangwan

et al. 2013

IJOO

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30 year old female patient with giant cell tumor of the distal tibia initially treated at a peripheral nononcological center by curettage and autologous bone grafting from the ipsilateral iliac crest reported to us with local recurrence and an implantation giant cell tumor at the graft harvesting site which required extensive surgeries at both sites. The risk of iatrogenic direct implantation of tumor, often attributable to inadequate surgical planning or poor surgical techniques, and the steps to prevent such complication is reported here.

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CASE REPORT: Iatrogenic Seeding of a Giant Cell Tumor of the Patella to the Proximal Tibia

Cited by 18 publications

References 18 publications

Distant metastasis of intraosseous dentinogenic ghost cell tumour to the donor site of a bone graft

Distant metastasis of intraosseous dentinogenic ghost cell tumour to the donor site of a bone graft

Does Wrist Arthrodesis With Structural Iliac Crest Bone Graft After Wide Resection of Distal Radius Giant Cell Tumor Result in Satisfactory Function and Local Control?

Iatrogenic giant cell tumor at bone graft harvesting site

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