Management of Primary Aggressive Tumors of the Knee

Abstract

Primary bone sarcomas and aggressive benign bone tumors are relatively rare. It is essential to recognize features that are concerning for these aggressive tumors based on a patient's history, physical exam, and radiographs. Physicians and other health care providers should have a high suspicion for these tumors and promptly refer these patients to orthopaedic oncologists. A multidisciplinary, team-based approach is required to obtain an accurate diagnosis and provide comprehensive care. This review discussed the appropriate work-up, biopsy principles, relevant peri-operative medical management, and surgical treatment options for patients with aggressive primary bone tumors around the knee. Primary bone sarcomas (osteosarcoma and chondrosarcoma) and aggressive benign bone tumors (giant cell tumor, chondroblastoma, and chondromyxoid fibroma) that have a predilection to the distal femur and proximal tibia are the focus of this review.

Images of giant cell tumor and chondroblastoma around the knee: retrospective analysis of 99 cases

“…Therefore, chondroblastoma is more likely when the maximum length of the tumor is <40 mm with no knee pain caused by obvious exogenous factors or sports system injury (e.g., trauma, fracture, meniscus and ligament injury), whereas GCTB is more likely when local symptoms around the knee joint are mild and the maximum length of the tumor is > 4 0 m m . H i s t o p a t h o l o g i c a l e x a m i n a t i o n o f chondroblastoma typically shows fluid exudation and inflammatory cell infiltration in the area of bone marrow edema (28), resulting in edema around the lesion >15 mm. Clinically, patients often present with local pain and peritumoral bone marrow edema, accompanied (or not) by surrounding soft tissue edema.…”