Giant Cell Tumor

What is a giant cell tumor?

A giant cell tumor is one that is made up of a large number of benign (non-cancerous) cells that form an aggressive tumor - usually near the end of the bone near a joint. The location of a giant cell tumor is often in the knee, but can also involve the bones of the arms and the legs, or the flat bones such as the sternum (breastbone) or pelvis.

Giant cell tumors most often occur in young adults when skeletal bone growth is complete. Most occur in the long bones of the legs and arms.

What causes giant cell tumors?

While the exact cause of giant cell tumors remains unknown, in some cases, they have been linked to Paget's disease. Paget's disease of the bone is a chronic bone disorder in which bones become enlarged and deformed.

What are the symptoms of a giant cell tumor?

The following are the most common symptoms of a giant cell tumor. However, each individual may experience symptoms differently. Symptoms may include:

• pain at the nearest joint

• a visible mass

• swelling

• bone fracture

• limited movement in the nearest joint

• fluid accumulation in the joint nearest the affected bone

The symptoms of a giant cell tumor may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

How is a giant cell tumor diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for giant cell tumors may include the following:

• x-rays - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film.

• radionuclide bone scans - a nuclear imaging method used to evaluate any degenerative and/or arthritic changes in the joints, to detect bone diseases and tumors, and to determine the cause of bone pain or inflammation. This test is to rule out any infection or fractures.

• biopsy - a procedure in which tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope to determine if cancer or other abnormal cells are present.

Treatment for a giant cell tumor:

Specific treatment for giant cell tumors will be determined by your physician based on:

• your age, overall health, and medical history

• extent of the disease

• your tolerance for specific medications, procedures, or therapies

• expectations for the course of the disease

• your opinion or preference

The goal for treatment of a giant cell tumor is to remove the tumor and prevent damage to the affected bone. Treatment may include:

• surgery (to remove the tumor and any damaged bone)

• bone grafting - a surgical procedure in which healthy bone is transplanted from another part of the patient's body into the affected area

• bone reconstruction

• amputation (may be required in severe cases)

• physical therapy (to regain strength and mobility)

   

Tumors that cannot be removed surgically can often be controlled and sometimes destroyed with radiation therapy. New therapies are being sought for giant cell tumors of bone, and recent clinical trials of the drug Denosumab have been promising. For unresectable tumors, ask your doctor about clinical trials.

Giant cell tumors can recur. Follow-up with a physician may be required for several years.