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A Rare Case Report of Giant Cell Tumor in the Distal Tibia: Management with Tumor Excision and Limb Reconstruction
V Harish Arvind1, K Tarun Prashanth1, M R Thirunthaiyan1
1Department of Orthopaedic Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Introduction:
Giant cell tumor (GCT) is a benign, locally aggressive neoplasm commonly affecting the ends of long bones. Treatment varies based on tumor stage and includes curettage, bone grafting, resection, wide excision, prosthetic reconstruction, radiation, and embolization. This case report presents a rare GCT of the distal tibia managed with wide excision and reconstruction with an Ilizarov ring fixator.
Case Report:
A 36-year-old male presented with progressively enlarging right ankle swelling for 3 months, accompanied by dull, diffuse pain aggravated by weight-bearing. He reported significant weight loss over 6 months but no history of trauma. Radiographs confirmed the diagnosis and higher investigations were done to stage the disease. After a multidisciplinary discussion with surgical oncology, he underwent wide excision and bone transport using an Ilizarov ring fixator.
Results:
The case was managed with the above-mentioned procedure, distraction was done for a period of 90 days, and the frame was removed after union at the docking site. Post-removal radiographs were done to confirm union at the distraction site and docking site. The patient gradually started weight-bearing in the limb.
Conclusion:
Periarticular long bone tumors can be managed effectively with resection and bone transport. Although it has a few disadvantages, such as the long duration of external fixator and pin tract infections, it remains a reliable option for limb reconstruction, offering cost-effectiveness and proven long-term success.
