Liquid Nitrogen Efficiency in Treatment of Giant Cell Tumor of Bone and Prevention of Recurrence

Abstract

Giant cell tumor (GCT) of bone is a benign aggressive bone lesion with significant recurrence rates following surgical curettage. Historically, these tumors were approached by performing an intralesional curettage of the tumoral tissue by filling the resulting cavity using morselized iliac bone autograft. The major problems of this therapy were the high recurrence rates of up to 40–50%. Several adjuvant treatments have been proposed in order to augment resection margins, including liquid nitrogen (LN), phenol, ethanol, hydrogen peroxide (H2O2) and bone cement (polymethyl methacrylate (PMMA)). LN can be used either to preserve tissues or for controlled necrosis depending on the cycles of freezing and thawing. Usually, a quick freeze followed by a slow thaw will lead to destruction of human cells. This article reviews the results of cryosurgery with LN associated with surgical resection and the additional use of PMMA in a small group of patients with a histopathological confirmation of bone GCT with different localizations (i.e., tibia, distal radius and iliac bone). Cryosurgery with LN of bone GCT proved to be an efficient tool to decrease the recurrence rate for this tumoral type. In our series of cases, there were no complications, oncological or otherwise, at the two-year minimum follow-up, with good and excellent functional results.

Case Report On Giant Cell Tumour In Distal End Of Radius Left Side Managed With Chemical Cauterization And Bone Grafting

“…Cellular membranes are often destroyed by a rapid freezing followed by a delayed thaw. The study looked at the outcomes of cryosurgery with liquid nitrogen,combined with surgical removal and the inclusion of Composite in a limited sample of patients who had histological evidence of bone GCT in various locations (tibia, distal radius, and iliac bone) (8). Giant cell tumour is a locally persistent tumour, and specific portion intralesional excision has a significant chance of recurrence.…”

The Role of C-Reactive Protein and Neutrophil to Lymphocyte Ratio in Predicting the Severity of Odontogenic Infections in Adult Patients

“…For instance, WBCs have a minimal role in the diagnosis and severity assessment of head and neck infections [ 13 ]; their significance lies mainly in the evaluation of the patient’s response to therapy. In comparison to odontogenic infections, CRP is a better infection measure than WBC because its level rises more rapidly [ 14 , 15 , 16 ]. CRP is present in minute quantities in healthy persons, increases quickly with infection within a few hours [ 17 ], and then rapidly decreases when the inflammation subsides.…”

Assessing Pretransplant and Posttransplant Therapy Response in Multiple Myeloma Patients

“…Patients who are eligible for a transplant have the highest survival rate at five years, which reaches about 80% with modern therapy, in contrast to elderly patients non-eligible for transplantation, whose survival rate is only about 20% at five years [ 13 , 14 ]. However, the prognosis continues to be higher compared with other more aggressive hematologic cancers and much higher than some solid tumors, considerably depending on a variety of prognostic factors [ 15 , 16 , 17 ]. Despite aggressive therapy that incorporates almost all available drugs and treatment options [ 18 , 19 , 20 ], strategies to overcome the side effects must be identified in high-risk patients and improve survival in this patient population.…”