Giant Cell Tumor in the Proximal Femur of an Eight-Year-Old Boy: A Case Report
GCT of Femoral Head in an eight-year-old.
,
Abstract
Background: Giant cell tumor (GCT) is a benign aggressive bone tumor that occurs mostly in young adult patients after puberty. The most common location is around the knee joint. Occurrence in pre-puberty pediatric patients is very rare and accounts for 1.8% to 10% of all known GCTs.
Case Report: Here, we report an eight-year-old boy who complained of pain and loss of range of motion (ROM) in the right hip. Radiological and pathological studies revealed GCT of the femoral head with joint expansion. We treated the patient by wide resection and osteochondral allograft reconstruction.
Conclusion: We believe this is the first reported case of GCT in the proximal femoral bone of pediatric patients, which is proven by pathology. Studying the current case may help tumor surgeons to become aware of this possibility.
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2. Mendenhall WM, Zlotecki RA, Scarborough MT, Gibbs CP, Mendenhall NP. Giant cell tumor of bone. Am J Clin Oncol. 2006;29(1):96-9. doi: 10.1097/01.coc.0000195089.11620.b7. [PubMed: 16462511].
3. Raskin KA, Schwab JH, Mankin HJ, Springfield DS, Hornicek FJ. Giant cell tumor of bone. J Am Acad Orthop Surg. 2013;21(2): 118-26. doi: 10.5435/JAAOS-21-02-118. [PubMed: 23378375].
4. Norouzi M, Naderi MN, Komasi MH, Sharifzadeh SR, Shahrezaei M, Eajazi A. Clinical results of using the proximal humeral internal locking system plate for internal fixation of displaced proximal humeral fractures. Am J Orthop (Belle Mead NJ). 2012;41(5):E64-8. [PubMed: 22715443].
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6. Chakarun CJ, Forrester DM, Gottsegen CJ, Patel DB, White EA, Matcuk GR, Jr. Giant cell tumor of bone: review, mimics, and new developments in treatment. Radiographics. 2013;33(1): 197-211. doi: 10.1148/rg.331125089. [PubMed: 23322837].
7. Nakhaie AM, Abdolahi KS, Moghtadaei M, Farahini H, Amiri S, Hajializade M. A study of characteristic features and diagnostic roles of X-ray and MRI in calcifying tendinitis of the shoulder. Med J Islam Repub Iran. 2022;36:79. doi: 10.47176/mjiri.36.79. [PubMed: 36128299]. [PubMed Central: PMC9448462].
8. Rezaei H, Shahrezaee M, Jalali MM, Ghorbani F, Zamanian A, Sahebalzamani M. Mussel-inspired polydopamine induced the osteoinductivity to ice-templating PLGA-gelatin matrix for bone tissue engineering application. Biotechnol Appl Biochem. 2021;68(1):185-96. doi: 10.1002/bab.1911. [PubMed: 32248561].
9. Balke M, Schremper L, Gebert C, Ahrens H, Streitbuerger A, Koehler G, et al. Giant cell tumor of bone: treatment and outcome of 214 cases. J Cancer Res Clin Oncol. 2008;134(9): 969-78. doi: 10.1007/s00432-008-0370-x. [PubMed: 18322700].
10. Cho HS, Park IH, Han I, Kang SC, Kim HS. Giant cell tumor of the femoral head and neck: result of intralesional curettage. Arch Orthop Trauma Surg. 2010;130(11):1329-33. doi: 10.1007/s00402-009-1026-2. [PubMed: 20020148].
11. Kulkarni SS, Dogra AS, Bhosale PB. Total hip arthroplasty for giant cell tumour. J Postgrad Med. 1996;42(3):82-4. [PubMed: 9715324].
12. Yeganeh A, Amiri S, Otoukesh B, Moghtadaei M, Sarreshtedari S, Daneshmand S, et al. Characteristic features and outcomes of open gunshot fractures of long-bones with Gustilo grade 3: A retrospective Study. Arch Bone Jt Surg. 2022;10(5):453-8. doi: 10.22038/ABJS.2021.52886.2624. [PubMed: 35755797]. [PubMed Central: PMC9194713].
13. Sakayama K, Sugawara Y, Kidani T, Miyawaki J, Fujibuchi T, Kamei S, et al. Diagnostic and therapeutic problems of giant cell tumor in the proximal femur. Arch Orthop Trauma Surg. 2007;127(10):867-72. doi: 10.1007/s00402-007-0419-3. [PubMed: 17713773].
14. Sharma V, Sharma S, Mistry KA, Awasthi B, Verma L, Singh U. Giant cell tumor of bone in skeletally immature patients - a clinical perspective. J Orthop Case Rep. 2015;5(4):57-60. doi: 10.13107/jocr.2250-0685.347. [PubMed: 27299101]. [PubMed Central: PMC4845459].
15. Mansfield CM, Stille G. Treatment of giant cell tumour of the femoral head and neck. J R Soc Med. 1987;80(6):396-7. Retrieved from. [PubMed: 3625700]. [PubMed Central: PMC1290876].
16. Saikia KC, Bhattacharyya TD, Bhuyan SK, Bordoloi B, Durgia B, Ahmed F. Local recurrences after curettage and cementing in long bone giant cell tumor. Indian J Orthop. 2011;45(2):168-73. doi: 10.4103/0019-5413.77138. [PubMed: 21430873]. [PubMed Central: PMC3051125].
17. Chen TH, Su YP, Chen WM. Giant cell tumors of the knee: Subchondral bone integrity affects the outcome. Int Orthop. 2005;29(1):30-4. doi: 10.1007/s00264-004-0613-7. [PubMed: 15647917]. [PubMed Central: PMC3456951].
18. Yeganeh A, Amiri S, Moghtadaei M, Otoukesh B, Solati A, Daneshmand S. Moderately elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) in patients with no clinical signs or symptoms of infection is not a contraindication for total knee arthroplasty: A retrospective cohort study. Current Orthopaedic Practice. 2022;33(1):52-5. doi: 10.1097/BCO.0000000000001070.
19. Campanacci M, Baldini N, Boriani S, Sudanese A. Giant-cell tumor of bone. J Bone Joint Surg Am. 1987;69(1):106-14. [PubMed: 3805057].
20. Haghighizadeh E, Shahrezaee M, Sharifzadeh SR, Momeni M. Transforming growth factor-beta3 relation with osteoporosis and osteoporotic fractures. J Res Med Sci. 2019;24:46. doi: 10.4103/jrms.JRMS_1062_18. [PubMed: 31160913]. [PubMed Central: PMC6540765].
21. Montgomery C, Couch C, Emory CL, Nicholas R. Giant cell tumor of bone: Review of current literature, evaluation, and treatment options. J Knee Surg. 2019;32(4):331-6. doi: 10.1055/s-0038-1675815. [PubMed: 30449024].
22. Mavrogenis AF, Igoumenou VG, Megaloikonomos PD, Panagopoulos GN, Papagelopoulos PJ, Soucacos PN. Giant cell tumor of bone revisited. SICOT J. 2017;3:54. doi: 10.1051/sicotj/2017041. [PubMed: 28905737]. [PubMed Central: PMC5598212].
23. Ein-Afshar MJ, Shahrezaee M, Shahrezaee MH, Sharifzadeh SR. Biomechanical evaluation of temperature rising and applied force in controlled cortical bone drilling: An animal in vitro study. Arch Bone Jt Surg. 2020;8(5):605-12. doi: 10.22038/abjs.2020.45014.2233. [PubMed: 33088862]. [PubMed Central: PMC7547161].
24. Sait SA, Nithyanath M, Cherian VM. Giant cell tumour of the distal humerus treated with elbow arthroplasty: A case report. Int J Case Rep Imag. 2012;3(4):37-40. doi: 10.5348/ijcri-2012-04-113-CR-10.
25. Shariatzadeh H, Bahrabadi M, Amiri S, Jahanshahi F, Joudi S, Bahrabadi M. Intra-articular osteoid osteoma of the capitulum: A diagnostic challenge. Clin Case Rep. 2022;10(5):e05796. doi:
10.1002/ccr3.5796. [PubMed: 35600026]. [PubMed Central: PMC9122796].
26. Rezaei H, Shahrezaee M, Jalali Monfared M, Fathi Karkan S, Ghafelehbashi R. Simvastatin-loaded graphene oxide embedded in polycaprolactone-polyurethane nanofibers for bone tissue engineering applications. J Polym Eng.2021;41(5):375-86. doi: 10.1515/polyeng-2020-0301.
27. Mankin HJ, Hornicek FJ. Treatment of giant cell tumors with allograft transplants: A 30-year study. Clin Orthop Relat Res. 2005;439:144-50. doi: 10.1097/01.blo.0000174684.85250.b5. [PubMed: 16205153].
28. Yuan Y, Liu Q, Liu Y, Wu Z, Zhong W, He H, et al. Comparative analysis of two surgical treatment options for giant cell tumor of the proximal femur: Extended curettage and segmental resection. Front Oncol. 2021;11:771863. doi: 10.3389/fonc.2021.771863. [PubMed: 34988016]. [PubMed Central: PMC8720996].
2. Mendenhall WM, Zlotecki RA, Scarborough MT, Gibbs CP, Mendenhall NP. Giant cell tumor of bone. Am J Clin Oncol. 2006;29(1):96-9. doi: 10.1097/01.coc.0000195089.11620.b7. [PubMed: 16462511].
3. Raskin KA, Schwab JH, Mankin HJ, Springfield DS, Hornicek FJ. Giant cell tumor of bone. J Am Acad Orthop Surg. 2013;21(2): 118-26. doi: 10.5435/JAAOS-21-02-118. [PubMed: 23378375].
4. Norouzi M, Naderi MN, Komasi MH, Sharifzadeh SR, Shahrezaei M, Eajazi A. Clinical results of using the proximal humeral internal locking system plate for internal fixation of displaced proximal humeral fractures. Am J Orthop (Belle Mead NJ). 2012;41(5):E64-8. [PubMed: 22715443].
5. Palmerini E, Picci P, Reichardt P, Downey G. Malignancy in giant cell tumor of bone: A review of the literature. Technol Cancer Res Treat. 2019;18:1533033819840000. doi: 10.1177/1533033819840000. [PubMed: 30935298]. [PubMed Central: PMC6446439].
6. Chakarun CJ, Forrester DM, Gottsegen CJ, Patel DB, White EA, Matcuk GR, Jr. Giant cell tumor of bone: review, mimics, and new developments in treatment. Radiographics. 2013;33(1): 197-211. doi: 10.1148/rg.331125089. [PubMed: 23322837].
7. Nakhaie AM, Abdolahi KS, Moghtadaei M, Farahini H, Amiri S, Hajializade M. A study of characteristic features and diagnostic roles of X-ray and MRI in calcifying tendinitis of the shoulder. Med J Islam Repub Iran. 2022;36:79. doi: 10.47176/mjiri.36.79. [PubMed: 36128299]. [PubMed Central: PMC9448462].
8. Rezaei H, Shahrezaee M, Jalali MM, Ghorbani F, Zamanian A, Sahebalzamani M. Mussel-inspired polydopamine induced the osteoinductivity to ice-templating PLGA-gelatin matrix for bone tissue engineering application. Biotechnol Appl Biochem. 2021;68(1):185-96. doi: 10.1002/bab.1911. [PubMed: 32248561].
9. Balke M, Schremper L, Gebert C, Ahrens H, Streitbuerger A, Koehler G, et al. Giant cell tumor of bone: treatment and outcome of 214 cases. J Cancer Res Clin Oncol. 2008;134(9): 969-78. doi: 10.1007/s00432-008-0370-x. [PubMed: 18322700].
10. Cho HS, Park IH, Han I, Kang SC, Kim HS. Giant cell tumor of the femoral head and neck: result of intralesional curettage. Arch Orthop Trauma Surg. 2010;130(11):1329-33. doi: 10.1007/s00402-009-1026-2. [PubMed: 20020148].
11. Kulkarni SS, Dogra AS, Bhosale PB. Total hip arthroplasty for giant cell tumour. J Postgrad Med. 1996;42(3):82-4. [PubMed: 9715324].
12. Yeganeh A, Amiri S, Otoukesh B, Moghtadaei M, Sarreshtedari S, Daneshmand S, et al. Characteristic features and outcomes of open gunshot fractures of long-bones with Gustilo grade 3: A retrospective Study. Arch Bone Jt Surg. 2022;10(5):453-8. doi: 10.22038/ABJS.2021.52886.2624. [PubMed: 35755797]. [PubMed Central: PMC9194713].
13. Sakayama K, Sugawara Y, Kidani T, Miyawaki J, Fujibuchi T, Kamei S, et al. Diagnostic and therapeutic problems of giant cell tumor in the proximal femur. Arch Orthop Trauma Surg. 2007;127(10):867-72. doi: 10.1007/s00402-007-0419-3. [PubMed: 17713773].
14. Sharma V, Sharma S, Mistry KA, Awasthi B, Verma L, Singh U. Giant cell tumor of bone in skeletally immature patients - a clinical perspective. J Orthop Case Rep. 2015;5(4):57-60. doi: 10.13107/jocr.2250-0685.347. [PubMed: 27299101]. [PubMed Central: PMC4845459].
15. Mansfield CM, Stille G. Treatment of giant cell tumour of the femoral head and neck. J R Soc Med. 1987;80(6):396-7. Retrieved from. [PubMed: 3625700]. [PubMed Central: PMC1290876].
16. Saikia KC, Bhattacharyya TD, Bhuyan SK, Bordoloi B, Durgia B, Ahmed F. Local recurrences after curettage and cementing in long bone giant cell tumor. Indian J Orthop. 2011;45(2):168-73. doi: 10.4103/0019-5413.77138. [PubMed: 21430873]. [PubMed Central: PMC3051125].
17. Chen TH, Su YP, Chen WM. Giant cell tumors of the knee: Subchondral bone integrity affects the outcome. Int Orthop. 2005;29(1):30-4. doi: 10.1007/s00264-004-0613-7. [PubMed: 15647917]. [PubMed Central: PMC3456951].
18. Yeganeh A, Amiri S, Moghtadaei M, Otoukesh B, Solati A, Daneshmand S. Moderately elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) in patients with no clinical signs or symptoms of infection is not a contraindication for total knee arthroplasty: A retrospective cohort study. Current Orthopaedic Practice. 2022;33(1):52-5. doi: 10.1097/BCO.0000000000001070.
19. Campanacci M, Baldini N, Boriani S, Sudanese A. Giant-cell tumor of bone. J Bone Joint Surg Am. 1987;69(1):106-14. [PubMed: 3805057].
20. Haghighizadeh E, Shahrezaee M, Sharifzadeh SR, Momeni M. Transforming growth factor-beta3 relation with osteoporosis and osteoporotic fractures. J Res Med Sci. 2019;24:46. doi: 10.4103/jrms.JRMS_1062_18. [PubMed: 31160913]. [PubMed Central: PMC6540765].
21. Montgomery C, Couch C, Emory CL, Nicholas R. Giant cell tumor of bone: Review of current literature, evaluation, and treatment options. J Knee Surg. 2019;32(4):331-6. doi: 10.1055/s-0038-1675815. [PubMed: 30449024].
22. Mavrogenis AF, Igoumenou VG, Megaloikonomos PD, Panagopoulos GN, Papagelopoulos PJ, Soucacos PN. Giant cell tumor of bone revisited. SICOT J. 2017;3:54. doi: 10.1051/sicotj/2017041. [PubMed: 28905737]. [PubMed Central: PMC5598212].
23. Ein-Afshar MJ, Shahrezaee M, Shahrezaee MH, Sharifzadeh SR. Biomechanical evaluation of temperature rising and applied force in controlled cortical bone drilling: An animal in vitro study. Arch Bone Jt Surg. 2020;8(5):605-12. doi: 10.22038/abjs.2020.45014.2233. [PubMed: 33088862]. [PubMed Central: PMC7547161].
24. Sait SA, Nithyanath M, Cherian VM. Giant cell tumour of the distal humerus treated with elbow arthroplasty: A case report. Int J Case Rep Imag. 2012;3(4):37-40. doi: 10.5348/ijcri-2012-04-113-CR-10.
25. Shariatzadeh H, Bahrabadi M, Amiri S, Jahanshahi F, Joudi S, Bahrabadi M. Intra-articular osteoid osteoma of the capitulum: A diagnostic challenge. Clin Case Rep. 2022;10(5):e05796. doi:
10.1002/ccr3.5796. [PubMed: 35600026]. [PubMed Central: PMC9122796].
26. Rezaei H, Shahrezaee M, Jalali Monfared M, Fathi Karkan S, Ghafelehbashi R. Simvastatin-loaded graphene oxide embedded in polycaprolactone-polyurethane nanofibers for bone tissue engineering applications. J Polym Eng.2021;41(5):375-86. doi: 10.1515/polyeng-2020-0301.
27. Mankin HJ, Hornicek FJ. Treatment of giant cell tumors with allograft transplants: A 30-year study. Clin Orthop Relat Res. 2005;439:144-50. doi: 10.1097/01.blo.0000174684.85250.b5. [PubMed: 16205153].
28. Yuan Y, Liu Q, Liu Y, Wu Z, Zhong W, He H, et al. Comparative analysis of two surgical treatment options for giant cell tumor of the proximal femur: Extended curettage and segmental resection. Front Oncol. 2021;11:771863. doi: 10.3389/fonc.2021.771863. [PubMed: 34988016]. [PubMed Central: PMC8720996].
| Files | ||
| Issue | Vol 9 No 4 (2023) | |
| Section | Case Report | |
| DOI | https://doi.org/10.18502/jost.v9i4.13939 | |
| Keywords | ||
| Giant Cell Tumors Giant Cell Tumor of Bone Allografts | ||
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How to Cite
1.
Taheriazam A, Mohammadnejad R, Baghbani S, Jabalameli F. Giant Cell Tumor in the Proximal Femur of an Eight-Year-Old Boy: A Case Report. J Orthop Spine Trauma. 2023;9(4):195-7.
