Management of Giant Cell Tumor of Talus With Extended Intralesional Curettage and Reconstruction Using Polymethylmethacrylate Cement

Abstract

An 18-year-old man presented with complaints of pain and swelling around the left ankle region. Local examination revealed diffuse, hard, mildly tender swelling with ill-defined margins over the medial aspect of the left ankle joint just below the medial malleolus. Radiographic and computed tomographic assessment revealed osteolytic lesion with moderately defined margins. Provisional diagnosis of Campanacci grade 2 giant cell tumor was made, which was later confirmed on histopathology. Extended intralesional curettage and reconstruction with polymethylmethacrylate cement was done under spinal anesthesia. Full weight bearing was allowed at 4 weeks when the below knee back slab was removed. Radiographic assessment was done every 3 months during the first year of follow-up and then every 6 months. No evidence of recurrence of tumor, collapse of talus, or avascular necrosis was found during follow-up. Managing such rare form of bone tumors with extended intralesional curettage and bone cement is an appropriate treatment and gives good functional results. Level of Evidence: Level V

Vertebral Primary Bone Lesions: Review of Management Options

“…Aggressive local tumor removal along with mechanical, thermal, and/or chemical adjuvant therapy depicts extended intralesional curettage. This is administered as a method of extending the tumor kill zone far beyond the limit of mechanical curettage [ 39 ]. A cortical window is obtained to allow for visualization of the bone lesion, followed by a mechanical adjuvant of a high-speed burr to increase the borders of the lesion area.…”