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Giant cell tumor of the hand in a pediatric patient: A case report
Herry Herman1, Adrian Fakhri Ismiarto1, Hans Kristian Handoko1
1Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, Indonesia.
Introduction And Importance:
Giant cell tumors (GCTs) of the hand are rare and typically present as painful, locally expanding masses. Bone grafting is commonly used after tumor removal to fill defects and restore structural integrity. This case highlights the management of a suspected GCT in a child using curettage, bone grafting, and biopsy.
Presentation Of Case:
A 12-year-old girl presented with a progressively enlarging lump on her right hand. Examination revealed a solid, immobile mass (3 × 2 × 1.5 cm) with a well-defined margin and reduced distal neurovascular function. The capillary refill time was less than 2 s. Surgical management included curettage, iliac bone graft harvesting, graft insertion, and fixation with a K-wire.
Clinical Discussion:
Curettage with bone grafting is the preferred treatment for GCTs, but it is associated with a risk of recurrence, especially in pediatric patients, due to rapid bone turnover and anatomical challenges in the hand. Iliac bone grafts provide structural support after curettage. Follow-up imaging is essential to detect early recurrence.
Conclusions:
Wide-scale local excision may offer better local control but can result in morbidity, particularly in the hands. Further research is required to clarify the long-term outcomes and optimize adjuvant therapy strategies.
