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Multicentric giant cell tumors of bone are rare; they represent less than 1% of all giant cell tumors. We report the case of a 24-year-old right-handed man, who presented in 1985 with a giant cell tumor of the upper end of the right humerus. After failure of conservative treatment (curettage and bone grafting), resection-arthrodesis of the shoulder with a free vascularised fibular autograft was performed. Three years later, the patient developed an osteolytic lesion of the lower end of the ipsilateral radius, involving the soft tissues and the wrist joint. He was treated with resection-arthrodesis of the wrist with a free vascularised fibular graft. View after 24 years for a new localization of the lower extremity of the humerus, which treated by curettage and bone grafting with a favorable postoperative (follow-up). The histologic study confirmed again the same diagnosis. After review of the literature, we report the uniqueness of this case report., (Copyright © 2012. Published by Elsevier SAS.)

Giant cell tumors (GCT) are locally aggressive tumors with a preference for epiphyses and metaphyses of long bones. They represent 5%-10% of all primary bone tumors. They affect mostly young adults between 20 and 40. Their origin remains uncertain. GCT is a purely lytic tumor, recurrent and can even lead to fracture. The distal radius is the third location after the distal femur and proximal tibia. Tumors are benign on histopathology, but "benign" lung metastases can sometimes be seen. Their treatment remains controversial because of the high rate of recurrence; oncological resection of the diseased bone segment with reconstruction reduces the rate of recurrence. Several techniques of resection and reconstruction of the wrist have been proposed. We report a case of giant cell tumor of the distal radius treated by resection and reconstruction by avascular fibular graft to a length of 12cm, and we evaluate the use of this reconstruction to salvage the wrist with this pathology., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Introduction: Giant cell tumors of bone (GCT) are usually benign and relatively rare. They have an aggressive behavior and an unpredictable prognosis. They occur mainly in the young adult, with a preferential localization in long bones. We report a giant cell infratemporal fossa tumor., Observation: A 55-year-old female patient consulted for swelling in the right cheek. Surgical excision was incomplete because of the subtemporal tumor localization. Histological assessment proved a GCT. Forty-five grays postoperative external radiotherapy was applied to the surgical site. The patient had local control at the 12-month follow-up., Discussion: GCTs are seldom observed in the facial skeleton (2%). The recommended treatment is surgery. Radiotherapy can be indicated in case of incomplete or impossible surgical excision, or when surgery would be responsible for a major functional deficit., (Copyright 2010 Elsevier Masson SAS. All rights reserved.)

Objectives: Through a novel observation of parathyroid adenoma revealed by brown tumors of the jaws and a review of the literature, the authors describe this rare mode of primary hyperparathyroidism discovery., Material and Methods: The patient was a 23-year-old woman who consulted for a recurrent tumefaction of the maxillary; histology showed reparative giant cell granuloma., Results: The clinical examination found an osseous tumefaction in continuity with the zygomatic bone and a gingival tumefaction on the mandible symphysis. The radiological findings showed two osteophytic lesions: mandibular and maxillary. The phosphocalcic metabolism was disturbed and the parathormone rate was high. The etiologic search consisted of a MRI of the neck, which showed a mass behind the thyroid gland, suggesting a parathyroid adenoma. The diagnosis was confirmed at surgical exploration. After removal of this tumor, the blood calcium rate dropped sharply and the bone tumefaction progressively regressed., Conclusion: Brown tumors are a rare mode of parathyroid adenoma discovery, and the jaw location is exceptional. The diagnosis is based on the parathormone rate, and radiological exams generally find the etiology. Treatment is based on surgery of the parathyroid adenoma.

Giant cell tumours (GCT) of bone are frequent, with variable behaviour, high risk of recurrence and an often benign histological appearance. Their location in the hand is uncommon, and there are few publications on the subject. Surgical treatment as described in the literature is very variable. We report a case of recurrent grade II GCT, arising in the proximal phalanx of the thumb, aggressive and causing a pathological fracture. After a surgical biopsy, we performed an "en bloc" resection of the first phalanx, with an iliac crest graft reconstruction and a double arthrodesis of the metacarpophalangeal and interphalangeal joint. No recurrence or lung metastasis was seen at 18 months follow-up.

Introduction: True giant-cell tumor is a rare jaw osteolytic benign tumor belonging to the larger family of giant-cell tumors. It is particular because of the risk of recurrence and potential metastatic spread., Observation: Since 1973, we have managed four cases of true giant-cell tumors in our unit. The three cases reported here concerned young patients who developed recurrence after tumorectomy-curettage., Discussion: Based on a literature review we defined this entity among the other giant-cell tumors. We emphasize the importance of early definitive diagnosis based on rigorous clinical and radiological confrontations. Because of its benign nature, the most conservative surgical treatment (tumorectomy-curettage) is generally proposed for the young patient. We noted however that in the three cases presented here, more radical surgical treatment with an enlarged tumorectomy removing the adjacent bone was advisable because of the high risk of recurrence and metastasis.

Introduction: Giant-cell tumors of bone are rare primary neoplasms commonly encountered in young adults. Women are slightly more affected than men., Case Report: We report the case a 27 year old woman presenting with a twelve months history of painful and progressively growing thoracic mass in the right anterior chest wall. Physical examination found out a fixed thoracic mass in the right retro-mammary area measuring 8 x 6 centimeters. The overlying skin was normal. Chest roentgenogram demonstrated a large ill defined mass continuing the anterior arc of the fourth right rib. Computed tomography evidenced a well defined pathologic process originating from the fourth right rib without expansion of the surrounding soft tissue. Pulmonary functional tests were normal and other complementary investigations evidenced no abnormalities. Our patient first had a fine needle cytological biopsy that brought strong suspicion of Giant-cell tumor of the rib. She then underwent an "en bloc" resection of the tumor whose histopathologic analysis allowed a definitive diagnosis. The post-surgical follow up during 12 months showed no signs of tumor recurrence., Conclusion: Through this observation the authors emphasize not only the rarity of the giant-cell tumors of bone but also its unusual costal localization (few cases reported till date). They focus on the importance of precocious screening and treatment and underline the value of the follow up in order to detect timely any sign of local recurrence or sarcomatous transformation. Finally, they report a current review of the literature.

We present a case of Ilizarov reconstruction after en bloc resection of the distal radius. An 8-cm resection was required to remove a giant-cell tumor. Reconstruction was based on the ascension technique using an Ilizarov external fixator after corticotomy of the proximal fragment of the radius. Satisfactory reconstruction with formation of a neoarticulation between the radius and the carpus was achieved. Satisfactory wrist function was achieved and the patient was recurrence free at five years. The arguments leading to this therapeutic option are discussed.

Osteoclast giant cell tumours are bone tumours that occur in adults, and that are considered benign by WHO but locally aggressive. Strictly identical tumours are described in the pancreas, without simultaneous bone localization. We report the case of a 62-year woman with an osteoclast giant cell tumour of the distal pancreas, without any epithelial component, which was diagnosed after pancreatic resection and with no signs of recurrence after a 24-month follow-up. These pancreatic tumours are rare, with a very poor prognosis, an unclear histogenesis; they are often confused with pleomorphic or undifferentiated pancreatic carcinomas including a component of osteoclast giant cell. These osteoclast giant cell tumours of the pancreas usually present as large cystic tumours. In certain cases, complete resection can result in long-term survival.

A case of giant-cell tumor of the third metacarpal bone is reported, treated with resection and reconstruction by iliac graft. At a 5 years follow-up, the cosmetic and functional results of the hand are good.

Giant-cell tumors are an infrequent clinical, radiological, and pathological entity observed in 5% of primary bone tumors. They generally occur at the epiphysis of long bones, particularly in the knee area but patellar localization seems very rare. Despite their perfectly benign histological aspect, giant-cell tumors may be aggressive, leading to local recurrence or even distant metastasis to the lung. We report a case of benign giant-cell tumor of the patella with lung metastasis observed in a 23-year-old woman. The aggressive radiological image was suggestive of chondrosarcoma. Histologically the differential diagnosis with chondroblastoma was difficult. The tumor and lung metastasis were treated by surgical resection. Four years later there has been no recurrence. We present the anatomic and clinical aspects of giant-cell tumor of the bone together with the diagnostic approach and the clinical course.

Multicentric giant cell tumors of bone are rare; they represent less than 1% of all giant cell tumors. We report the case of a 35-year-old right-handed man, who presented in 1985 with a giant cell tumor of the upper end of the right humerus. After failure of conservative treatment (curettage and bone grafting), resection-arthrodesis of the shoulder with a free vascularized fibular autograft was performed. Three years later, the patient developed an osteolytic lesion of the lower end of the ipsilateral radius, involving the soft tissues and the wrist joint. He was treated with resection-arthrodesis of the wrist with a free vascularized fibular graft. The histologic study confirmed the diagnosis of giant cell tumor of similar grade. After 13 years follow-up, the patient had a satisfactory function of the limb and no recurrence of the tumor was noted.

We report four cases of primary bone tumour of the distal radius. Follow-up averaged ten years with a range of four to 13. Each case underwent excision of the tumour followed by reconstruction with a non-vascularised fibular graft. The aim of our study was to investigate the carcinologic, functional and radiological results at an average of ten years after the initial surgery. There were three high grade osteosarcomas and one giant cell tumour of bone. The mean postoperative wrist flexion was 45 degrees, extension was 20 degrees, pronation 30 degrees and supination 50 degrees. Radial tilt was a mean 10 degrees and ulnar tilt 15 degrees. All the patients had satisfactory function so as to be able to perform activities of daily living and to work. Grip strength was normal in three cases and reduced in one. Bone graft healing occurred at a mean of six months with a range of from four to nine months. Resection followed by a non-vascularised fibular graft is an effective way to managing these patients.

Purpose of the Study: Giant-cell tumor are known for local recurrence. Metastases are rare (2 p. 100), and generally located in the lung. We present a case with multiple bone metastases and rapid course., Material, Methods and Results: A 45-year-old man presented a 5 cm giant-cell tumor of his right distal tibia and two other localisation in the fifth and sixth cervical vertebral bodies. He underwent a resection of the distal tibia and reconstruction with a controlateral free vascularized fibula. The bodies of the fifth and sixth cervical vertebral were resected and replaced by an iliac crest graft. Other localisations appeared in iliac right crest, in the posterior wall of the cotyle and in the second, third and fourth cervical vertebral bodies. Chemotherapy was administered and clinical signs regressed but eight months later the patient presented a recurrence of his tumor in the distal tibia with new localisation in the left fifth rib, in the right clavicle, in the frontal bone, in right ischio-pubal branch and in the right proximal femur. A new chemotherapy was performed but had little effect and probably hasved dubic death 13 month after the first symptom., Discussion: The present observation is characterised by the large number of localisations (13; the highest number found in the literature was 11 localisations) and by the rapidity of the clinical course. Low grade giant-cell tumors generally give benign metastase with a course lasting several years. The chemotherapy helpt us to slow the progression of the lesions but was unable to prevent the development of new localisation and the recurrence in the distal tibia. More over, its toxicity could have caused the death of the patient., Conclusion: We present the case of one patient who presented a giant-cell tumor with unusual presentation: multiple bony metastases with rapidly fatal outcome.

The distal end of the radius is one of the sites commonly affected by giant-cell tumor of bone; it poses problems of reconstruction after resection of the distal radius. The authors present a retrospective study of 5 giant cells tumors treated by resection-arthrodesis of the wrist. These tumors were seen in 3 men and 2 women. From the radiological point of view, all tumors were extensive and lytic lesions centered in the epiphysis and involving the metaphysis; the wrist joint was respected. From the histological point of view, the tumors were grade I in 3 cases and grade II in 2 cases. With a mean follow up of 8 years, the results were considered good in 3 cases, fair in 1 case and poor in 1 case. A high incidence of bone complications was noted: delayed union (up to 11 months) and fracture of the graft, which occurred in 3 patients.

Giant cell tumors of bone are uncommon in the vertebrae above the sacrum. We report the case of a giant cell tumor of the third lumbar vertebra, revealed by lumbar and radicular pain. X ray, computed tomography and magnetic resonance imaging showed osteolysis of the body and vertebral arch of L3. Histologic evaluation gave a conclusion of a giant cell tumor, grade 2. Spondylectomy of L3 was performed using a combined approach (anterior and posterior) in two stages. The patient had a good functional result without recurrence at three years and six months. A review of the literature indicates that the radiological appearance is nonspecific but shows the extent of the tumor. Diagnosis can be based only on histological features. Radiotherapy could induce malignant transformation. Radical resection limits the risk of recurrence. Total spondylectomy is recommended for giant cell tumors when both the body and arch are involved.

He is a 46 year old patient that consults on a tumor that deforms the back of his left hand. The X-ray examination shows a bone osteolytic tumor with complete dis appearance of the 4th metacarpal. Surgical removal of the tumor was practiced with immediate reconstruction of the 4th metacarpal by an oseo-iliac graft. Anatomopathological examination. It is an ovoid tumor 6.5 long and irregular surface.