Preserving Approach in Management of Femur Giant Cell Tumor with Curettage and Bone Grafting in an Adult Patient: Case Report

Abstract

Background: Giant cell tumors (GCTs) are benign bone tumors that can be locally aggressive, leading to joint destruction or pathologic  fractures. In rare cases, they can progress to lung metastasis and death. The management modalities of GCTs include medical treatment,  curettage, cryotherapy, and resection and reconstruction, including arthroplasty.

Objective: The current case report aimed to discuss  alternative treatment options to the reported case of GCT. Case report: The reported case showed a healthy 25-years-old man with left  hip joint pain progressing over six months. The pain was resistant to lifestyle modifications and medications. Investigations resulted in  the diagnosis of a GCT in the left femur head. The management included a preoperative course of denosumab, surgical dislocation of the left hip, lesion curettage, irrigation, and bone graft and cementation. Our plan was a good alternative because it is a low-cost surgery that  resulted in regaining the same previous level of activities without limitations. The plan showed excellent outcomes, but more cases  and long-term follow-up are needed in further studies. The aim of the case report was to discuss alternative treatment options for the  reported case of GCT.

Conclusion: A criterion standard treatment option for GCT in the femur is lacking. In the current case, a GCT of the femoral head was treated with an initial course of denosumab for six months, followed by curettage, bone grafting and cementing  packing. The outcome showed that this alternative modality yielded functionally and radiologically acceptable results. In addition, the  treatment plan was simple and cost-effective.