S. Kamatha, b, , , M. Janea and R. Reida
aWestern Infirmary, Glasgow G11 6NT, United Kingdom bWhiston Hospital, Prescot L45 5DR, United Kingdom
Giant cell tumour (GCT) has been known to behave unpredictably when located in the foot and ankle bones. Involvement of foot and ankle bones is rare and comprises of less than 4% of all the GCTs. Out of 175 cases of GCT documented in the Scottish Bone Tumour Registry, 8 cases arose from foot and ankle. The mean age was 28.8 years (1347). These included six males and two females. Pain and swelling was the common mode of presentation. All the cases had minimum follow-up of 36 months (36180) and had definitive treatment within the first 3 months of initial presentation. The Campannacci radiographic staging system was used in grading the tumours. Seven of eight cases had intralesional procedure, while the remaining one had primary below knee amputation. One case had local recurrence within 2 years of the initial treatment requiring further surgery. Five out of seven cases with curettage involved the distal tibia or fibula. We had one recurrence of the three cases involving the tarsal bones, which reflects the difficulty in achieving thorough curettage in small bone tumours.
Thorough curettage and bone grafting with adjuvant therapy has a low recurrence rate and should be considered when possible particularly in the long bones. Use of bone cement may be a better option in small bone involvement in view of difficulty in achieving thorough curettage. Regular follow-up helps detect early recurrence.
Foot and Ankle Surgery Volume 12, Issue 2 , 2006, Pages 99-102.