Multicentric giant cell tumor around the knee.

Area of Science:

• Orthopedic Surgery
• Oncology
• Radiology

Background:

• Giant cell tumor (GCT) of bone is a relatively uncommon primary bone tumor.
• Multicentric GCT, occurring in multiple distinct sites, is exceptionally rare.
• Synchronous GCTs in all three bones around the knee (femur, tibia, patella) represent a unique presentation.

Purpose of the Study:

• To report an extremely rare case of multicentric giant cell tumor.
• To highlight the synchronous occurrence of GCT in the distal femur, proximal tibia, and patella.
• To discuss the diagnostic and therapeutic approach for this rare presentation.

Main Methods:

• Case presentation of a 33-year-old male with knee swelling and pain.
• Diagnostic imaging including plain X-ray of the right knee.
• Histopathological confirmation via fine needle aspiration cytology and biopsy.
• Surgical treatment utilizing curettage, bone grafting, and methyl methacrylate cementing (Sandwich technique).

Main Results:

• Radiographic findings revealed expansile lytic lesions in the lateral condyle of the femur, lateral tibia condyle, and patella.
• Histology confirmed the diagnosis of giant cell tumor of the bone.
• The patient underwent successful treatment with a combined surgical approach.

Conclusions:

• Multicentric giant cell tumor of the bone is a rare entity, with synchronous involvement of all three knee joint bones being exceedingly uncommon.
• Accurate diagnosis relies on a combination of imaging and histopathology.
• The 'Sandwich technique' involving curettage, bone grafting, and methyl methacrylate cementing offers a viable treatment option for such complex cases.