Differential diagnoses and therapeutic features of giant cell tumor of the bone in an elderly patient: A case report

• Published in: International journal of surgery case reports Vol. 124; p. 110467
• Main Authors: Zrig, Makram, Othman, Youssef, Chaouech, Firas, Maatouk, Mezri, Zrig, Ahmed, Abid, Abderrazek
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-11-2024; Elsevier
• Subjects: Bone cement; Bone grafting; Case Report; Elderly patient; Giant cell tumor; Bone grafting; Elderly patient; Case report; Bone cement; Giant cell tumor
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2024.110467

Giant cells tumor (GCT) of the bone is usually seen in young adults between the ages of 20 and 40. When occurring in older patients, diagnosis and therapeutic specific feature are to be considered. We underline those aspects through this case report.
We report the case of a 73-year-old man presenting with a painful swelling knee. The diagnosis of GCT of proximal tibia was retained and the patient underwent extensive curettage, subchondral bone grafting and cementation of the residual cavity. The long-term results show a good functional outcome and no recurrence.
In this age group, other lesions have similar clinical and radiological presentations as GCT of bone. The diagnosis of a metastatic carcinoma is to be carefully ruled-out in this situation. While the option of large resection with joint arthroplasty is better accepted in ageing patients as a treatment of GCT of bone, this case suggests that jointpreserving methods should also be considered especially when there are no signs of osteoarthritis. While polymethylmethacrylate cementation is an efficient adjuvant in order to reduce recurrences, it may cause secondary osteoarthritis. Subchondral grafting seems to be a good alternative to prevent this complication.
Malignancies should be ruled-out before retaining the diagnosis of GCT of the bone after the age of 50. Conservative surgical treatment is always an option in this age group.
•Chondrosarcoma is a differential diagnosis for giant cell tumors of the bone.•Giant cell tumor of the bone could be a complication of Paget's disease in elderly.•Subchondral bone grafting prevents cartilage collapsing after wide curettage.