Abstract
Giant cell tumor of bone is a benign albeit aggressive tumor commonly affecting the
bones of the knee. Patients with these tumors present with pain, swelling, and inability
to bear weight on the involved extremity. These destructive tumors typically arise
in the metaphyseal region of the long bones in individuals in the second, third, and
fourth generations of life. Histologically, the multinucleated giant cells are the
hallmark of the lesion, easily recognized on histological review, which recently have
become therapeutic targets for medical management of the disease. For decades, surgical
management has been the primary treatment for giant cell tumor of the bone. Some tumors
can be treated with excision and filling of the osseous void with bone cement or allograft.
This is an effective treatment option with a low to moderate risk of local recurrence
while preserving limb function. For more destructive tumors, wide excision and reconstruction
with prosthetic, structural allograft or combined allograft prosthetic components
are utilized. Advances in medical management of the disease have also demonstrated
promise as an effective treatment; however, its use has usually been limited to the
treatment of metastatic disease, recurrent disease or when advanced local disease
would require surgical treatment felt to be overly morbid.
Keywords
giant cell tumor of bone - distal femur - proximal tibia - knee - denosumab
