Soft-tissue recurrence of giant cell tumor of bone: a case report

We report a rare complication of giant cell tumor [GCT] of bone. A soft tissue recurrence without intra-osseous involvement developed in a 35-year-old lady treated for grade III GCT with intralesional excision, local adjuvant phenol and filling the cavity with bone cement. The different imaging modalities used for work-up and staging are discussed. This report emphasizes that a soft tissue recurrence may be not recognized if a thorough clinical examination is not performed and MRI is not done. Review of relevant literature addressed different factors that influence recurrence, as well as the role of osteoinductive growth factors in stimulating the osteoblastic differentiation and metaplastic bone formation in such lesions

Prophylactic fixation of impending pathological fractures due to metastatic bone disease

Management of patients with metastatic bone disease [MBD] represents a true challenge to all disciplines involved in the treatment of these patients. Pathological fracture is one of the most important skeletal related events that necessitate active orthopedic intervention. Prophylactic fixation of such fractures is less traumatic to the patients and less demanding to the surgeon. Thirty four patients with 39 impending pathological fractures due to MBD were treated by prophylactic fixation of their affected bones. Thirteen were males and 21 were females. The ages ranged from 42 to 76 years with an average of 55 years. Eighty percent of the operated patients were ambulatory immediately after surgery and nearly all of them had significant pain relief. Average hospital stay was 8 days, average operative time was 70 minutes, and complications were reported in 13 cases. The survival rate was 65% at one year, 44% at 2 years and 26% at 3 years post-operatively. Prophylactic fixation of an impending pathological fracture is technically easier, has low rate of complication and protects patients from the distress of actual fracture. A multimodality approach is important to optimize care and quality of lives to this sector of patients