Periacetabular giant cell tumor treated with intralesional excision and allograft reconstruction

Giant cell tumors of the acetabulum are uncommon lesions. Their diagnosis is often delayed due to their slow progression, late onset symptoms and easily been obscured by bowel gas in plain pelvic radiographs. The tumor size is always very large at the time of diagnosis, with major nerve and joint involvement. Management of such tumor remains challenging to orthopedic surgeons. Between 1992 and 1999, 3 acetabular giant cell tumors were diagnosed and managed at our institution. The treatment modality was intralesional tumor excision with structural allograft reconstruction. The margin of tumor was routinely managed with high-speed burring and phenol application. All 3 patients were free of local recurrence at a mean follow-up of 89 months. Postoperative palsy of sciatic nerve occurred in 1 patient, but no complications such as wound infection or fracture were seen. The nerve palsy recovered completely 1 year later. The final functional outcome of the 3 patients was excellent. The result appears that intralesional excision with adjuvant therapy is feasible in the management of giant cell tumor of the acetabulum and is able to obtain a satisfactory outcome.