Giant cell tumour of the patella with local recurrence: successful management with excision, curettage and artificial bone grafting

Abstract

Primary patellar neoplasms are rare, comprising 0.12% of primary bone tumours; thus, no standardised treatment related to staging exists. 70%-90% of primary patellar neoplasms are benign or intermediate with giant cell tumour (GCT) being the most common. GCTs are locally aggressive, have a high recurrence rate and metastasise in 1%-2%. We report the case of a 23-year-old man with histologically confirmed recurrent GCT of the patella to demonstrate that aggressive surgical management options described in the literature, such as patellectomy with or without complex reconstruction, may be excessive and cause patients undue morbidity. Initially, the patient underwent intralesional curettage with excellent recovery, but presented again with a local recurrence within a year. A further definitive operation was performed which included excision of the inferior pole followed by curettage of the patellar body and artificial bone grafting. The patient made a good recovery and at 5-year follow-up has maintained good function.

Reconstruction of the extensor mechanism using polypropylene mesh in a displaced pathological fracture of the patella affected by giant cell tumour

“…While contained lesions can be effectively treated with curettage, preserving the patella, the presence of a displaced pathological fracture complicates treatment. There is a scarcity of literature on managing giant cell tumour of the patella when accompanied by a pathological fracture 4 5. In such cases, patella excision might be necessary, and reconstruction of the extensor mechanism becomes crucial.…”

“…In such cases, patella excision might be necessary, and reconstruction of the extensor mechanism becomes crucial. This task is critical due to the extensive soft tissue damage, the risk of tumour recurrence and the goal of restoring function 4 5. Various methods, including autograft, allograft, rotational flaps and more recently, polypropylene mesh, have been employed with success 3–8.…”

“…This task is critical due to the extensive soft tissue damage, the risk of tumour recurrence and the goal of restoring function 4 5. Various methods, including autograft, allograft, rotational flaps and more recently, polypropylene mesh, have been employed with success 3–8. However, autografts may be insufficient, allografts carry risks of disease transmission and are often scarce, and local flaps require considerable surgical skill and come with the issue of donor site morbidity.…”

Giant Cell Tumor of Patella with Secondary Aneurysmal Bone Cyst-A Rare Case Report of Anterior Knee Pain in Young Adults

“…However the occurrence of a symbiotic tumor where both these components coexist is relatively rare [ 4 ], with only a handful of cases reported to date. The presenting symptoms are usually chronic knee pain with occasional swelling of a non-traumatic origin in young individuals, which is not intensively investigated and is often treated with analgesics or reassurance, citing over-exertional physical activity as the predisposing cause [ 5 , 6 ]. Patellar tumors are not frequently included in the differentials for anterior knee pain, and this often leads to missing these tumors in the early stages [ 7 ].…”

Giant Cell Tumour of the Patella: A Missing Differential Diagnosis in the Young

“…Despite its scarcity and prevalence in knee joints, patients typically present with anterior knee pain, joint swelling, and an exacerbating pain at rest. Due to etiologies more common than GCT, such as the patellar tendinitis, the diagnosis of the former is often delayed [ 6 ].…”