Introduction:
A giant cell tumor of bone or Osteoclastoma is a rare, benign (noncancerous) type of tumor with a tendency to become aggressive spreading to other sites (metastasis). Most often, these tumors develop at the ends of the long bones like femur (thighbone) or upper end of the tibia (shinbone).
- Location/ Site(s) of occurrence – These tumors often develop in the knee joint but can occur in other joints and/or other types of bones as well.
- Age & gender predilection – Generally, it occurs in adults of age group 20 – 40 years basically after the completion of bone growth; more common in females.
Causes:
There are no known and specific giant cell tumor causes identified yet; might occur spontaneously or sometimes is associated with hyperparathyroidism.
Symptoms:
Symptoms of giant cell tumor may comprise of:
- Pain in the area of the tumor or nearby joint movement; increases with activity and decreases with rest.
- Pain associated with swelling in associated area.
- Limited range of motion of the nearby joint.
- Bone fractures due to bone weakening by the tumor, known as a pathological fracture.
- Sometimes weakness or numbness, and/or a pricking sensation in the arms and legs.
Diagnosis:
Giant cell tumor diagnosis usually starts with a clinical examination followed by:
- Imaging modalities such as X-ray (radio-graph)
- Later a bone cancer specialist might ask for confirmatory tests/scans like:
- CT scans
- MRI scans
- Biopsy of the bone
Treatment:
Giant cell tumor treatment should be started as soon as it is diagnosed to avoid any further destruction of the surrounding bone. The goals of Giant cell tumor treatment are:
- Removal of the tumor
- Prevention of further damage to the bone
Giant cell tumor treatment can compose of:
- Surgical treatment – Curettage, Bone graft
- Non-surgical treatment modalities – Chemotherapy, radiation therapy or radiotherapy, targeted therapy
The treatment of choice for Giant cell tumor is surgery. However, there can be some cases where surgery is not effective. Such cases require nonsurgical treatment options.
- Surgical treatment:The giant cell tumor surgery or giant cell tumor of bone treatment surgically can be done using the following methods:
- Curettage: For local tumor control, surgical treatment along with curettage is the optimal treatment. Curettage is the commonly performed surgical procedure to treat giant cell tumors. In this procedure, the tumor part is scrapped-out of the bone. Later, ‘bone cementation’ or bone filling is done in the scrapped area with an aim of strengthening the affected bone and destroying any remaining tumor cells. The substance for bone cementation used is usually ‘polymethyl methacrylate’ or PMMA. PMMA cementation in defect filling has shown good results. The exothermic reaction of PMMA produces a local rise in temperature, which causes damage to the cancerous cells/tissue in and nearby that site while sparing the normal cells/tissues. Other substances for this purpose can be phenol, liquid nitrogen.
- Bone graft – A bone graft is a part of bone taken from either patient’s own body (autograft), most commonly hip in case of autograft or from a other person/ donor (allograft) used to fill the cavity created after curettage which helps stabilize the affected and operated bone. Or a bone-cement mixture can also be used for the same purpose in case of small holes/cavities. To reduce the risk of the cancer recurring back (recurrence), additional chemicals, such as liquid nitrogen, hydrogen peroxide, or phenol, are also placed inside the bone cavity to reduce the risk of recurrence.
In cases where the tumor has caused excessive destruction of bone, a more complex surgical removal and reconstruction might be required. This intervention is made especially in giant cell tumor recurrence treatment. The bone tumor specialist may go for using bone grafts, artificial joints, or a both to help reconstruct the bone, joint, or soft tissue structures affected. The ultimate goal is proper rehabilitation of the affected joint/bone/soft tissue to restore back in its functional form so that so that the patient can easily perform his/her daily activities.
- Non-surgical treatment modalities:
- Chemotherapy – At present, there are no recognized and particularly effective giant cell tumor chemotherapy agents available. Occasionally, a few of them are used in giant cell tumor recurrence treatment to further reduce the risk of recurrence.
- Radiotherapy – Radiotherapy is reserved for cases where complete excision or curettage cannot be done due to any medical or functional or locational reasons, say, lesions of the spine and sacrum or for aggressive tumors. Radiotherapy when given post-surgery may help improve the control of the tumor. However, administering radiation in these tumor-types can increase the risk of a benign and less aggressive form of a giant cell tumor to transform into a malignant (cancerous) one, later in the patients’ life. This condition is known as a radiation induced sarcoma.
- Targeted therapy – Targeted therapy targets a specific molecule/protein which is malfunctioning either over expressed or mutated in this cancer type unlike the healthy cells. Targeted therapy for giant cell tumor of bone, aims to destroy the giant cells which make up the tumor, thereby allowing the surgery to minimally impact the appearance and functionality of the affected bone. Patients mostly need to undergo regular X-rays which helps assess the effect of therapy on the tumor and to estimate the best time to operate.
It could be concluded that every case is different and the treatment outcome after treatment depends on many factors like:
- Patient’s age
- Size, stage and location of the tumor
- The method of treatment
Giant cell tumors have tendency to recur, therefore regular follow-up visits to the specialist doctor, maybe for a number of years after treatment is necessary to keep a check.
American Oncology Institute provides best and precision cancer care!
We, at American Oncology Institute, being one of the best giant cell tumor hospitals in Hyderabad, are always committed and aligned to provide the best and extensive level of cancer care services to our patients. American Oncology Institute offers its patients with one of the best giant cell tumor treatment in Hyderabad along with its team of highly-experienced, skilled and one of the best giant cell tumor specialists from across the country.
American Oncology Institute is equipped with advanced and modern technologies for an effective screening, diagnosis and treatment of both cancerous and non-cancerous bone and soft tissue tumors in addition to providing comprehensive care for genetic and acquired bone cancers.
American Oncology Institute provides with almost all treatment solutions for musculoskeletal cancers including targeted therapy, radiation and surgical options such as mega-prosthesis, reconstruction implants, bone grafts, and so many. Our integrated experts of surgical, medical and radiation oncologists work together to understand the patient’s unique diagnosis requirement and formulates an effective treatment plan.
