Giant cell tumour of bone with late presentation: review of treatment and outcome.
PURPOSE: To review cases of giant cell tumour of bone or osteoclastoma managed at the University Malaya Medical Center, University of Malaya, Kuala Lumpur, from January 1990 to December 1999. METHODS: Medical records of all patients with musculoskeletal tumours were reviewed. Demographic data, clinical presentation, surgical management, and clinical outcomes were reviewed retrospectively. RESULTS: Most of the 31 patients who were treated for giant cell tumour of bone presented late on the basis of the duration of their symptoms and radiological features. Five of the patients had been referred for local recurrences. 26 patients were treated for primary tumours: 18 needed wide excision, 7 curettage, and one amputation. The joint could not be preserved and arthrodesis was performed for 11 patients. Three (12%) of the 26 patients had local recurrence during a mean follow-up of 60 months, including one (6%) who had recurrence after wide excision and 2 (29%) after curettage. Pulmonary metastasis was noted in 4 cases, 2 of which were confirmed histologically. CONCLUSION: Even in an advanced stage of disease, good clinical outcomes can be achieved with adequate excision and appropriate reconstruction. For lesions around the knee, autologous rotational grafting is a good alternative method of reconstruction.