Soft tissue recurrence of giant cell tumor of the bone: Prevalence and radiographic features

Leilei Xu; Jing Jin; Annan Hu; Jin Xiong; Dongmei Wang; Qi Sun; Shoufeng Wang

doi:10.1016/j.jbo.2017.09.002

Soft tissue recurrence of giant cell tumor of the bone: Prevalence and radiographic features

J Bone Oncol. 2017 Sep 20:9:10-14. doi: 10.1016/j.jbo.2017.09.002. eCollection 2017 Nov.

Authors

Leilei Xu¹, Jing Jin², Annan Hu¹, Jin Xiong¹, Dongmei Wang², Qi Sun³, Shoufeng Wang¹

Affiliations

¹ Department of Orthopedic Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing 210008, China.
² Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China.
³ Department of Pathology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China.

Abstract

Aim: Recurrence of giant cell tumor of bone (GCTB) in the soft tissue is rarely seen in the clinical practice. This study aims to determine the prevalence of soft tissue recurrence of GCTB, and to characterize its radiographic features.

Methods: A total of 291 patients treated by intralesional curettage for histologically diagnosed GCTB were reviewed. 6 patients were identified to have the recurrence of GCTB in the soft tissue, all of whom had undergone marginal resection of the lesion. Based on the x-ray, CT and MRI imaging, the radiographic features of soft tissue recurrence were classified into 3 types. Type I was defined as soft tissue recurrence with peripheral ossification, type II was defined as soft tissue recurrence with central ossification, and type III was defined as pure soft tissue recurrence without ossification. Demographic data including period of recurrence and follow-up duration after the second surgery were recorded for these 6 patients. Musculoskeletal Tumor Society (MSTS) scoring system was used to evaluate functional outcomes.

Results: The overall recurrence rate was 2.1% (6/291). The mean interval between initial surgery and recurrence was 11.3 ± 4.1 months (range, 5-17). The recurrence lesions were located in the thigh of 2 patients, in the forearm of 2 patients and in the leg of the other 2 patients. According to the classification system mentioned above, 2 patients were classified with type I, 1 as type II and 3 as type III. After the marginal excision surgery, all patients were consistently followed up for a mean period of 13.4 ± 5.3 months (range, 6-19), with no recurrence observed at the final visit. All the patients were satisfied with the surgical outcome. According to the MSTS scale, the mean postoperative functional score was 28.0 ± 1.2 (range, 26-29).

Conclusions: The classification of soft tissue recurrence of GCTB may be helpful for the surgeon to select the appropriate imaging procedure to detect the recurrence. In addition, the marginal resection can produce a favorable outcome for the patients.

Keywords: Giant cell tumor of bone; Prevalence; Radiographic features; Recurrence.