Wide resection giant cell tumor of distal ulna and stabilization ulnar stump with extensor Carpi ulnaris tendon (2 case reports)

• Published in: International journal of surgery case reports Vol. 74; pp. 58 - 62
• Main Authors: Mujaddid, I., Pamudji, U., Savero, I., Handry, Th, Brian, W.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-01-2020; Elsevier
• Subjects: Case report; Distal ulna; Giant cell tumor; Musculoskeletal tumor society score; Stabilization of ulnar stump; Wide resection; Stabilization of ulnar stump; Case report; Musculoskeletal tumor society score; Giant cell tumor; Wide resection; Distal ulna
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2020.07.071

•The distal Ulna is an unusual site (0.45%–3.2%) for a primary bone GCT.•The functional reconstruction of the defect after resection has been a challenge.•Many surgeons try to retain the ulna and perform the only curettage and packing with polymethylmethacrylate. Unfortunately, there is a high recurrence rate of up to 40% when treated in such a manner.•Wide resection of the distal ulna with or without reconstruction or stabilization of the ulnar stump is the recommended treatment for GCTs in such locations.•We present two patients with GCT of the distal ulna, all of them treated by wide resection of the distal ulna followed by stabilization of the remaining ulna using one half of the extensor carpi ulnaris (ECU) tendon. All the patient satisfied with the treatment.
Giant-cell tumor (GCT) of bone occurred in the distal end of the ulna is extremely uncommon. Wide resection is usually indicated in such cases and at times it may be necessary to remove a long segment of the distal ulna. The functional reconstruction of the defect after resection has been a challenge. Wide resection of the distal ulna with or without reconstruction or stabilization of the ulnar stump is the recommended treatment for GCTs in such locations.
There were 2 cases of giant cells tumor of the distal ulna. They treated with wide resection and stabilization of ulnar stump by extensor carpi ulnaris tendon. We were evaluating outcomes using the Musculoskeletal Tumor Society (MSTS) Score for the upper extremity. The results from the evaluation of the MSTS Score were an average of 24 points.
There were 2 patients. All of them present with lumps of their wrist and the pain over the lump. Patients treated with wide resection and stabilization of ulnar stump by extensor carpi ulnaris. The result from the evaluation of the Musculoskeletal Tumor Society (MSTS) score were 24 points.
Giant cell tumor of bone is a rare, generally benign, locally invasive tumor. The ulna distal extremity is an unusual site for a primary bone GCT. Any ulnar resection proximal to the insertion of the pronator quadratus can lead to instability in the form of radio-ulnar convergence and dorsal displacement (winging) of the ulnar stump. This can result in a diminution of forearm rotation and weakness with grasp. The main goal of stabilization is the stable, pain-free, and functional outcome of the wrist. In this cases report our patient with giant cell tumor were treated with wide resection and stabilization of ulnar stump by extensor carpi ulnaris. All of the patients satisfied with our treatment.