Giant Cell Tumor

As GCT is a benign tumor, the goal of treatment would be to conserve the neighboring joint and retain patient’s normalcy as much as possible. The treatment of Giant Cell Tumor consists of a surgery. A special type of surgery is offered to the patients of GCT which is known as “Radical Intra-lesional curettage”. A large window is made in the wall of the bone to expose all the nooks and corners of the disease cavity. All the tumor tissue is removed in pieces with help of variety of instruments known as scoops. A surgeon will be able to remove what is visible to him. However, if the procedure is concluded at this point, the microscopic tumor (which is not visible naked eye) will be left behind. This will lead to recurrence of the tumor. Conventionally, the recurrence rates reported in medical literature are in range of 40 to 60%! “Radical Intra-lesional curettage”. surgery tackles this microscopic disease. Some adjutants are used to kill the microscopic disease. mechanical agents like A high speed burr, thermal agents like laser / electrocautery and chemical agents like phenol are used to kill the residual tumor cells. With this kind of aggressive removal of even microscopic tumor cells, the recurrence rates have reduced to less than 5%! Once the curettage is done, the defect or cavity is filled with either Bone grafts (harvested from patient’s own body) or bone cement. In some patients, plate fixation id also done to augment the strength to the construct. In very large giant cell tumors, sometimes the curettage method is not possible or unsafe. In this kind of situation, complete resection of the tumor is done followed by reconstruction with joint replacement or other methods.

Once the treatment is over, patient needs to follow up on regular bases irrespective of any problems for next 5 years. It is only then, that the patient is declared free of tumor!