Recurrence of Giant Cell Tumor in Fibular Graft Used for Treatment in Primary Giant Cell Tumor of Distal End Radius: A Case Report and Surgical Treatment with Excision of Tumor with Proximal Row Carpectomy with Ulnocarpal Fusion

Abstract

Introduction: Giant cell tumor (GCT) at Distal End Radius (DER) have relatively aggressive nature and higher recurrence rate and malignant transformation than their other counterparts. There is no case reported till now of GCT recurrence in grafted fibula used for reconstruction in managing primary DER-GCT. The purpose of the study is to report the recurrence of GCTin fibular graft used for treatment in primary GCT of DER.

Case report: A 40-year-old female was diagnosed with Campanacci Type 3 GCT-DER 7-year back. The patient was operated and treated by excision of tumor and reconstruction with contralateral fibular grafting with K-wire fixation of DER7-year back and biopsy of growth was sent. After 7 years, the patient again developed swelling over the right wrist and radiological diagnosis of GCT Campanacci Grade 3 is made. She is managed by resection of tumor tissue by volar approach to DER with proximal row carpectomy with ulnocarpal fusion with retrograde K-wire fixation of the 3rd metacarpal resulting in centralization of ulna.

Conclusion: Recurrence in GCT also occurs at donor fibula used in reconstruction for primary treatment and could be safely managed by wide excision and centralization of ulna with good results.

Keywords: Giant cell tumor; distal end radius; fibula graft; recurrence.