Giant cell tumours in hand bones

ABSTRACT

To describe the clinical features of Giant cell tumour of hand, in terms of aggressiveness, multicentricity and radiological grading at presentation, surgical procedures and final outcome. A case series. Jinnah Postgraduate Medical Centre [JPMC], Karachi, from January 1990 to January 2009. Seven cases of Giant cell tumour of hand bones were diagnosed in last 19 years and included in this study. Patients with infections in hand and procedure performed at other centre were excluded. Clinical and radiographic features were analyzed, definitive operative procedures performed and follow-up of the patient were studied and updated. Two hundred ten cases of Giant cell tumour of bones were seen in last 19 years at JPMC, Karachi; 7 cases were of GCT of hand bones which constitutes around 3.3% of all GCT. Four patients [57%] were male and 3 [43%] female with mean age of 24.28 +/- 5.7 years. Four [57%] cases were in metacarpal and 3 [43%] in phalanges. Average duration of symptoms was 5.78 +/- 3.26 months; all presented with radiological stage 3 lesions. One case of multicentric lesion presented after treatment of primary GCT of distal radius. Excision of the tumour and reconstruction by autogenous graft was performed in 6 cases and ray amputation in one case. No complication or recurrence noted in any case on an average of 4.5 years [ranging from 1.5-8 years] follow-up. Giant cell tumour in hand bones is rare tumour and shows specific clinical and radiographic features with early involvement of entire bone, more aggressive behaviour and multi centricity. The treatment of choice is resection of the tumour with reconstruction or ray amputation