Massive giant-cell tumor of pelviacetabulum explained

Giant-cell tumor (GCT) of the pelvis is uncommon, accounting for only 1.5 to 6% of cases of GCT.[1] In pelvis ilium is the most common site of involvement; ischium and pubis are less frequently involved.[2] It typically presents in adults between age of 20 to 50 with localized swelling and pain.[3] Females are slightly more affected than males.[4]

Average size of the tumor in this region is 9.5 cm.[5]

There are different modalities of treatment of pelvic GCT. Radiotherapy has high rate of recurrence (44%) and risk of soft tissue sarcomas (12%).[6] Thus treatment should be essentially surgical which includes surgical excision. Excision can be extralesional which achieves 90% local tumor control but poor functional outcome [7] or it can be intralesional which has 90% local recurrence rate with good functional outcome.[8] Massive GCT of pelvis, which is static, not amenable to excision and presenting with mechanical symptoms, can be managed by de-bulking the portion of tumor responsible for mechanical symptoms. And patients need to be followed for local invasion or metastasis.[9]

Notes and References

  1. Cheng MT, Chen TH, Chen WM. Periacetabular giant cell tumor treated with intralesional excision and allograft reconstruction. J Chin Med Assoc 2004;67:537-41
  2. Patne SC, Kumar M, Sadaf L. Giant-cell tumor of the pubic bone: A case report. Int J Orthop Surg 2009;15:1148
  3. Blake SM, Gie GA. Large pelvic giant cell tumor: A case report and a review of current treatment modalities. J Arthroplasty 2004;19:1050-4
  4. Sanjay BK, Frassica FJ, Frassica DA. Treatment of giant-cell tumor of the pelvis. J Bone Joint Surg Am 1993;75:1466-75
  5. Sanjay BK, Frassica FJ, Frassica DA. Treatment of giant-cell tumor of the pelvis. J Bone Joint Surg Am 1993;75:1466-75
  6. Leggon RE, Zlotecki R, Reith J. Giant Cell Tumor of the pelvis and sacrum. Clin Orthop Relat Res 2004;423:196-207
  7. Gitelis S, Mallin BA, Piasecki P. Intralesional excision compared with en bloc resection of giant cell tumors of bone. J Bone Joint Surg 1993;17:1648-55
  8. Bloodgood JC. The conservative treatment of giant cell sarcoma, with the study of bone transplantation. Ann Surg 1912;56:210-39
  9. Ali N, Bhat A, Muzzafar K, Bhat SA. Giant 'giant cell tumor' of pelvis. J Sci Soc 2012;39:98-9

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