Limb Salvage Surgery in Fungating Giant Cell Tumors: A Report of Three Cases

Rangaswamy, Namith; Kumar, Venkatesan Sampath; Banjara, Roshan; Majeed, Abdul; Goyal, Devansh; Khan, Shah Alam

doi:10.13107/jocr.2021.v11.i02.2008

Cited by 3 publications

(7 citation statements)

References 10 publications

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“…The meshplasty is another technique that exploits the properties of a folded polypropylene mesh in determining intense fibrosis in surrounding tissue and providing adequate strength to stabilize the joint ( Fig. 4A ) ( 17 , 37 ). Prajapat et al describe the technique as easy, reproducible, and with minimal complications ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

“…A summary of patients treated with resection of the distal fibula and reconstruction modalities such as arthrodesis, arthroplasty, and other reconstruction options is presented in Table 4 ( 17 , 18 , 22 , 31 , 37 , 44 , 64 , 65 , 66 , 68 , 69 ). Mansour and Ghanem ( 66 ) reported on a two-staged procedure described as a variant of the Masquelet technique ( Fig.…”

Section: Discussionmentioning

confidence: 99%

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Reconstructive surgery after distal fibular resection due to bone tumors: a technical report on surgical strategies and results from the PROSPERO international register of systematic reviews

Angelini,

Bohacek,

Plecko

et al. 2024

EFORT Open Reviews

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Purpose Primary bone tumors of the fibula are rare. Distal fibular resection has a significant impact on ankle biomechanics and gait, possibly leading to complications such as ankle instability, valgus deformity, and degenerative changes. Question: Is there a need for reconstructive surgery after distal fibular resection, and what reconstructive procedures are available? Materials and methods The review is registered with the PROSPERO International Register of Systematic Reviews. Inclusion criteria consisted of all levels of evidence, human studies, patients of all ages and genders, publication in English, and resection of the distal portion of the fibula due to tumor pathology. The reviewers defined four different categories of interest by method of treatment. Additional articles of interest during full-text review were also added. Results The initial search resulted with a total of 2958 records. After screening, a total of 50 articles were included in the study. Articles were divided into ‘No reconstruction’, ‘Soft tissue reconstruction’, ‘Bone and soft tissue reconstruction’, and ‘Arthrodesis, arthroplasty or other reconstruction options’ groups. Conclusion Limb salvage surgery should be followed by reconstruction in order to avoid complications. Soft tissue reconstructions should always be considered to stabilize the joint after fibular resection. Bone reconstruction with reversed vascularized fibula is the preferred technique in young patients and in cases of bone defects more than 3 cm, while arthrodesis should be considered in adult patients. Whenever possible for oncologic reason, if a residual peroneal malleolus could be preserved, we prefer augmentation with a sliding ipsilateral fibular graft.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Reconstructive surgery after distal fibular resection due to bone tumors: a technical report on surgical strategies and results from the PROSPERO international register of systematic reviews

Angelini,

Bohacek,

Plecko

et al. 2024

EFORT Open Reviews

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“…GCTs of the distal fibula are a rare occurrence, as evident by the fact that there are only seven studies to date that report the occurrence of GCTs involving the distal fibula [4,[15][16][17][18][19][20]. These tumors are catastrophic and destroy the affected bone, thus affecting the mobility of the respective joint.…”

Section: Discussionmentioning

confidence: 99%

“…Another interesting case study published by Rangaswamy et al elaborates on a bleeding lesion at the lateral malleolus of the left leg that manifested as a recurrence of a GCT of the distal fibula that was treated by curettage a year before. The tumor was resected, and mesh and screws were used to stabilize the joint [18]. The Campanacci grading system has been utilized for the classification of GCT based on the radiographic appearance.…”

Section: Discussionmentioning

confidence: 99%

Giant Cell Tumor of the Distal Fibula Managed by an Autologous Proximal Fibula Graft

Muhammad¹,

Salman²,

Sahito³

et al. 2023

Cureus

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A giant cell tumor of the bone is among the most common bone tumors encountered by orthopedic surgeons. These benign and aggressive tumors are most commonly present around the knee joint; however, rare cases may involve the distal fibula. An 18-year-old man presented with a painless swelling of the lateral aspect of the left ankle. Clinical examination, radiologic evaluation, and biopsy confirmed the diagnosis of a giant cell tumor of the distal fibula. The patient was treated with resection of the distal fibula followed by reconstruction using an ipsilateral proximal fibula graft. The post-operative recovery was uneventful, and the patient was doing well on the last visit, one month after the intervention.

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“…Ten percent of cases are located at the distal radius [6]. It was reported that distal radius GCT could exhibit larger sites and be more aggressive than usual [5]. Tumor sites of ≥ 5 cm in diameter had a 3.893 times higher rate of recurrence [2].…”

Section: Discussionmentioning

confidence: 99%

Limb Salvage Surgery in Large and Fungating Giant Cell Tumors of Distal Radius: A Case Series

Budi,

Abidin

2023

Indonesian Journal of Cancer

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Introduction: A Giant Cell Tumor (GCT) is a benign tumor, but often aggressive with recurrence or metastasis tendency. Often, distal radius GCT is presented in relatively small or medium sizes. Large and fungating distal radius GCT is characterized by its higher ability to infiltrate, destruct, and compromise its surrounding tissue. Therefore, it increases the risk of complications including amputation. The treatment requires more complex surgery and reconstruction than usual GCT. In this case series, we prefer to perform the limb salvage surgery with wide en bloc resection, followed by reconstruction of the bone and soft tissue, instead of amputation. Case Presentation: We report 4 patients with massive GCT at the distal radius. All complained about pain and a lump in the wrist. The tumors are large in dimension with the size of 12 x 8 x 6 cm, 10 x 10 x 8 cm, 11 x 9 x 9 cm, and 17 x 14 x 8 cm respectively, fungating and compromised surrounding soft tissue. Limb salvage procedures are performed with wide en-bloc resection, bone cement spacer insertion, K-wire fixation, dissection, and tendon reconstructions followed by soft tissue defect closure using distant flap and primary suture. Follow-up post-surgery was variable within 2 to 36 months. All patients had a reduced scale of VAS, increased functional outcome measured with quick DASH score, no major complications, and no sign of recurrence or metastasis during the follow-up period. Conclusion: Large and fungating GCT of distal radius managed by limb salvage surgery and complex reconstruction deliver a good result. Thus, it can give other options other than amputation.

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Limb Salvage Surgery in Fungating Giant Cell Tumors: A Report of Three Cases

Cited by 3 publications

References 10 publications

Reconstructive surgery after distal fibular resection due to bone tumors: a technical report on surgical strategies and results from the PROSPERO international register of systematic reviews

Reconstructive surgery after distal fibular resection due to bone tumors: a technical report on surgical strategies and results from the PROSPERO international register of systematic reviews

Giant Cell Tumor of the Distal Fibula Managed by an Autologous Proximal Fibula Graft

Limb Salvage Surgery in Large and Fungating Giant Cell Tumors of Distal Radius: A Case Series

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