Giant cell tumor of the small bones of the foot

This study aims to determine whether giant cell tumor of bone of the foot (GCTB-F) is more aggressive than GCTB at other sites using data from a single institution.

We reviewed all patients with GCTB seen by our Unit from 1993 to 2012. Patients with GCTB-F were compared with all other patients with GCTB in terms of demographics and presentation. This group of GCTB-F was then compared with patients with GCTB of the appendicular skeleton (GCTB-AS) in terms of treatment and oncologic outcome at follow-up of at least 2 years.

There were seven patients with GCTB-F (2.6%), most consulted over 12 months after symptoms. Compared to other GCTB ( n = 262), a bigger proportion of patients (28.5%) presented as recurrent lesions. All seven patients were classified as Campanacci III but none had lung metastasis at presentation or on follow-up. Compared to the group of 124 GCTB-AS, no GCTB-F patient received intralesional surgery. The 14% recurrence rate can be explained by contaminated non-intralesional surgery due to the advanced presentation and the technically challenging architecture of the foot. It would seem the aggressive tag of GCTB-F is not due to aggressive biologic behavior but to a combination of delayed presentation, delayed diagnosis, and difficult surgery.