Giant Cell Tumor of Bone in Northern India -Incidence, Clinical Presentation, Radiology, Histopathology and Treatment Approach

Giant cell tumor is relatively uncommon benign locally aggressive neoplasm. and is still a challenge to the Surgeons in the developing countries due to limited diagnostic and therapeutic facilities.

This study was conducted to determine the clinical pattern of Giant cell tumors including their relative frequencies as per age and sex distributions, anatomical sites of occurrence, radiological features, histopathology features analysis and treatment approach in a tertiary care hospital of North India.

This is a retrospective study of all the histopathologically confirmed Giant cell tumors seen at Safdarjang Hospital New Delhi and S.M.S. Greater Noida over a 9 year period. During this period total number of primary bone tumors were 1170.Out of these 128 were diagnosed as Giant Cell tumors and 108 cases were followed up and forms the basis of the study.

Out of 108 patients there were 57 males and 51 females. Their ages ranging from 11 to 55 years with an average of 28 years. The most common sites of the lesions were the ends of long bones (90 cases), especially the distal femur (24 cases), proximal tibia (31 cases) and distal radius (11 cases). The histological pattern of giant cell tumor was rather uniform. The indispensable feature of giant cell tumor was, giant cell itself. Microscopic evidence of malignancy was found in one of our cases of giant cell tumour of recurred lesion.Various forms of treatment included were curettage, en- bloc resection and radiation.

Incidence of GCT was 9 % of all primary tumors.Microscopic evidence of malignancy was found in one of our cases of giant cell tumour of recurred lesion.Histological grading has little prognostic value. Benign histology does not necessarily relate to the clinical behavior of the tumor. Resection yielded the best result. Radiation therapy should be reserved for surgically inaccessible tumor because of high risk of recurrence and malignant transformation.