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Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: the knee is the anatomical region where most benign and malignant tumors affecting the human skeleton are found, including giant cell tumor. Patient information: male, 28 years old, white, with no morbid health history, who came to the Orthopedics and Traumatology outpatient clinic for presenting a tumor at the level of the right knee accompanied by pain that appeared two years ago, but has increased in size rapidly in the last two months. Imaging tests and incisional biopsy were performed to confirm the diagnosis. The multidisciplinary team decided to amputate the limb. Conclusions: giant cell tumor is a disease that occurs more frequently from the third to the fifth decade of life; its main complications are recurrence, pulmonary metastasis and malignant transformation. Patients with the latter complication require procedures such as limb amputation. [ABSTRACT FROM AUTHOR]

Os autores descrevem caso clínico de tumor de células gigantes refratário a vários tratamentos, onde empregou-se com sucesso a ressecção distal do úmero com colocação de endoprótese não convencional de Fabroni (ENCF). Esta prótese parcial preserva o olecrânio, evitando a luxação e ulceração cutânea do cotovelo, e apresenta chapa de metal no sulco intercondiliano para evitar necrose óssea. Um ótimo resultado funcional foi obtido, além de seguimento de 3 anos sem recidiva ou complicações cirúrgicas.

Reportamos un paciente con diagnóstico de tumor de Células Gigantes. Dicho tumor antes conocido como Osteoclastoma es poco frecuente, presentándose en la juventud, más en mujeres que en hombres, siendo benigno en la mayoría de casos. En este artículo se muestran criterios diagnósticos radiológicos que nos pueden servir de guía.

Se presenta un caso de gonalgia por causa tumoral en rótula en una paciente femenina. Por el incremento de sintomatología y limitación funcional en corto tiempo, se había programado para biopsia y aplicación de injerto óseo y/o polimetilmetacrilato, pero en el acto quirúrgico fue necesario realizar patelectomía total por el masivo compromiso rotuliano ocasionado por un tumor de células gigantes (TCG).

The case report of a 58 years patient is described. She went to the Orthopedics and Traumatology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba because she began to notice progressive increase of volume in the back of the left hand around 5 years ago, near the metacarpusphalangic articulation of the third finger that made its extension difficult and was unsightly. By means of the scan, a well defined echogenic image that infiltrated the thickness of the tendon was observed, reason why the exeresis of the tumor was carried out. The infiltration of this tendon was confirmed, which was dried up and substituted with self-graft of the accessory tendon that sends the ring finger tendon. The results of the histologic studies reported that it was a giant cell tumor of the sheath with tendinous infiltration. The hand was immobilized during 3 weeks and the functional recovery was completed at 45 days.

Introduction: giant cell tumor (GCT) is a benign intramedullary bone tumor that frequently arises at the ends of long bones. After the distal femur and proximal tibia, the distal radius is the third most affected site with particularly aggressive tumors. Our objective is the presentation of the clinical case of a patient diagnosed with distal radius GCT classified in grade HI of Campanacci who received a treatment adjusted to her economic possibilities. Case report: a 47-year-old female, without economic solvency and with some medical service. Treatment included block resection, reconstruction with distal fibula autograft, and radiocarpal fusion with blocked compression plate. Eighteen months later, the patient had good grip strength (80% on the healthy side) and had fine motor function in the hand. The wrist presented stability with pronation of 85°, supination of 80°, flexion-extension of 0° and a score of 6.7 in the DASH functional outcomes assessment questionnaire. His radiological evaluation five years after his surgery continued with no evidence of local recurrence and pulmonary involvement. Conclusion: the result in this patient, together with the published data, indicate that the block tumor resection technique, plus distal fibula autograft and arthrodesis with blocked compression plate provide an optimal result of functionality for the grade III distal radial tumor at low cost. [ABSTRACT FROM AUTHOR]

The case report of a 58 years patient is described. She went to the Orthopedics and Traumatology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba because she began to notice progressive increase of volume in the back of the left hand around 5 years ago, near the metacarpusphalangic articulation of the third finger that made its extension difficult and was unsightly. By means of the scan, a well defined echogenic image that infiltrated the thickness of the tendon was observed, reason why the exeresis of the tumor was carried out. The infiltration of this tendon was confirmed, which was dried up and substituted with self-graft of the accessory tendon that sends the ring finger tendon. The results of the histologic studies reported that it was a giant cell tumor of the sheath with tendinous infiltration. The hand was immobilized during 3 weeks and the functional recovery was completed at 45 days. [ABSTRACT FROM AUTHOR]

El tumor de células gigantes espinal es una neoplasia de estirpe benigna y comportamiento local agresivo, de presentación rara en la población pediátrica. El dolor asociado al compromiso neurológico es la presentación típica en niños. La resección amplia del tumor y la descompresión de los elementos neurales asociada a fusión instrumentada permiten obtener una columna estable, preservar o restaurar la función neural y evitar la recidiva tumoral. Se presentan dos pacientes con tumor de células gigantes espinal en esqueleto inmaduro, sometidos a resección y estabilización mediante artrodesis instrumentada, sin recidiva en el posoperatorio alejado. La presentación clínica, la edad de los pacientes y los resultados quirúrgicos a largo plazo hacen de extremo valor el reporte de estos casos en esqueletos inmaduros.

Central giant cell granuloma (GCCG) is an intraosseous, non-neoplastic lesion that most frequently affects the anterior mandible region. Its etiology is still uncertain, and its development may be aggressive or not. In this study, we presented a case of aggressive GCCG in a young patient in the anterior maxilla region, with extensive bone resorption, cortical perforation. The patient's treatment used corticosteroids, but the lesion did not regress; then, the complete removal of the lesion was performed, and then, the extraction of teeth associated with immediate reconstruction was performed. The patient was and continues to be followed up without signs of recurrence. [ABSTRACT FROM AUTHOR]

Introduction: Primary bone tumors make up 1% of cancers in adults, the most common being osteosarcoma and chondrosarcoma. Giant cell tumor (GCT) is a locally aggressive benign neoplasm, accounting for 4-10% of all primary bone tumors, but in certain populations it accounts for up to 20%. The main objective of this work was to determine the proportion of GCTs, osteosarcomas and chondrosarcomas in a period of five years, and describe the characteristics of the patients from whom they come. Clinical implications: More information about the epidemiology of bone tumors is required to know their epidemiology in the Mexican population. Material and methods: Descriptive observational study of a retrospective cross section including all patients who underwent surgery for tumoral resection, in public hospitals at national level, and whose histopathological pieces were processed and resulted in tissue compatible with a) GCT, b) osteosarcomas and c) chondrosarcomas. Results: Between 2013 and 2017, 138 cases of the three primary bone tumors studied were reported, giant cell tumor (50%), osteosarcoma (25.36%) and chondrosarcoma (24.64%). The states with the highest number of cases were the state of Mexico (45.65%) and Mexico City (26.81%). Women had a higher prevalence (57.25%) than men (42.75%). The average age of presentation of the tumors was 36.80 years. Conclusions: GCT is not an uncommon tumor in the Mexican population, since it has its own characteristics. [ABSTRACT FROM AUTHOR]

El radio distal es la tercera localización en frecuencia para los tumores de células gigantes. El curetaje de la lesión más relleno de la misma con cemento, es una de las opciones de tratamiento. La cementación tras el curetaje puede tener complicaciones y obligar a la resección de la zona dañada. Presentamos el resultado de un caso, donde se hizo resección en bloque de la zona tumoral cementada más reconstrucción del área con translocación del cúbito y artrodesis de la muñeca. Es una técnica sencilla en la que se pierde movilidad, pero que consigue excelentes resultados clínicos y funcionales en mano y antebrazo.

Resumen Objetivos: Conocer la capacidad diagnóstica de las diferentes pruebas de imagen empleadas en nuestro centro. Valorar si la distribución de las diferentes variables que definen la tumoración es la misma en los tumores con y sin recidiva. Material y método: Se valoraron 54 casos de tumor de células gigantes de la vaina tendinosa de la mano. En todos se realizó una radiografía, en 19 ecografía y en 7 resonancia magnética. Los datos analizados fueron: sexo, edad, antecedente traumático, dedo afecto, localización, resultado de las pruebas de imagen, características anatomopatológicas de la tumoración (tamaño y número de nódulos), y presencia o no de recidiva. Resultados: Se objetivó 1,7 mujeres por cada varón. La mano derecha y el segundo dedo fueron las localizaciones más frecuentes. Ninguna radiografía fue diagnóstica; la ecografía tuvo un valor predictivo positivo de 36,8% y la resonancia magnética de 71,4%. Hubo 6 casos de recidiva, sin relación estadísticamente significativa entre la recidiva y el tamaño, el número de nódulos o la artrosis. Conclusión: La resonancia magnética tiene una capacidad diagnóstica superior a la ecografía, y esta, superior a la radiografía simple. No se ha encontrado ninguna asociación estadísticamente significativa entre la recidiva de la lesión y los factores estudiados.

The case reports of 2 patients assisted in the out-patient Orthopedics Deparment of "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba are presented. One had been surgically treated 3 years ago due to a giant cells tumor in the proximal third of the left radius, with a satisfactory clinical course until it began to present volume increase and pain in the distal third of his radio that limited the wrist's flexoextension; the other patient had suffered a traumatism in the distal third of the left forearm and it presented increase of volume between the egdes of the dorsal and ventral sides of the forearm and the wrist. The exeresis to the tumors, with resection in block and external fixation with bank bone implants dedicated to this in the province were carried out. Both patients were discharged without complications and Orthopedics and Oncology follow-up were indicated.

Se describe el caso de un paciente de 75 años de edad atendido en la consulta de traumatología del Centro de Diagnóstico Integral con quirófano "Calilo García" en el Estado de Apure, de la República Bolivariana de Venezuela, quien desde hacía 3 años aproximadamente había sufrido un traumatismo en el dorso del pie izquierdo, por lo cual presentaba aumento de volumen, de crecimiento relativamente lento, adherido a planos profundos, no doloroso a la palpación profunda. Los estudios radiográficos del pie resultaron normales y en la ecografía de partes blandas se visualizaron imágenes de bordes mal definidos con celularidad en su interior. Se realizó la exéresis del tumor y los resultados de la biopsia confirmaron que se trataba de una sinovitis vellonodular. La evolución fue satisfactoria y el paciente se reincorporó a sus actividades habituales

The case reports of 2 patients assisted in the out-patient Orthopedics Deparment of "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba are presented. One had been surgically treated 3 years ago due to a giant cells tumor in the proximal third of the left radius, with a satisfactory clinical course until it began to present volume increase and pain in the distal third of his radio that limited the wrist's flexoextension; the other patient had suffered a traumatism in the distal third of the left forearm and it presented increase of volume between the egdes of the dorsal and ventral sides of the forearm and the wrist. The exeresis to the tumors, with resection in block and external fixation with bank bone implants dedicated to this in the province were carried out. Both patients were discharged without complications and Orthopedics and Oncology follow-up were indicated. [ABSTRACT FROM AUTHOR]

Copyright of West Indian Medical Journal is the property of West Indian Medical Journal (WIMJ) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Se realizó la presentación de un caso con un tumor de células gigantes en el extremo distal del fémur derecho a nivel del cóndilo femoral interno. Se retira quirúrgicamente, previo estudio, donde se confirmó el diagnóstico a través de la biopsia. En dicho proceder se efectuó un raspado extenso de la lesión respetando la superficie articular del cóndilo femoral, rellenando la cavidad con la hidroxiapatita HAP-200 ®, sin necesidad de apoyar dicho acto con una osteosíntesis interna o externa, sólo con una calza de yeso por 6 semanas. El seguimiento del paciente ha sido, hasta la fecha, de 6 años y no se ha reportado ninguna recidiva o metástasis, con una osteointegración positiva del biomaterial, lográndose la curación ósea y una función articular sin restricción.

El granuloma reparativo central de células gigantes es una lesión proliferativa no neoplásica de etiología desconocida. Se presenta un paciente masculino de 40 años de edad, portador de prótesis parcial superior. Fue remitido al Servicio de Cirugía Maxilofacial del Hospital "V. I. Lenin" por presentar aumento de volumen en reborde alveolar superior, de color rojo grisáceo y que provocaba expansión de corticales óseas. Una vez analizados los exámenes clínicos, radiográficos e histopatológicos se diagnosticó un granuloma reparativo central de células gigantes Se realizó exéresis quirúrgica de la lesión y extracción de dientes adyacentes con una evolución satisfactoria sin señales de recidivas luego de tres años del tratamiento. El granuloma reparativo central de células gigantes se presentó como respuesta a un trauma. La correcta interpretación de los datos clínicos, radiográficos e histopatológicos nos permitió llegar al correcto diagnóstico y plan de tratamiento.

O caso em questão é o de uma paciente do sexo feminino que apresentava queixa de dor na região anterior do joelho esquerdo durante e após atividades esportivas, seguidas de bloqueio articular havia três meses. Exames de imagem: radiografias simples do joelho normais e ressonância magnética mostrando formação expansiva sólida podendo corresponder a condroma de partes moles ou a sinovite nodular focal. Realizada ressecção artroscópica da lesão com diagnóstico de tumor de células gigantes difuso símile/sinovite vilonodular pigmentada localizada (SVNPL) após resultado do exame anatomopatológico. A paciente apresenta boa evolução clínica com desaparecimento dos sintomas e retorno às atividades físicas.This case concerned a female patient with a complaint of pain in the anterior region of her left knee during and after sports activities, followed by joint blockage three months ago. From imaging examinations, simple radiography of the knee was normal and magnetic resonance showed a solid expansive mass, possibly corresponding to soft-tissue chondroma or focal nodular synovitis. Arthroscopic resection of the lesion was performed, and the diagnosis of diffuse giant cell tumor resembling localized pigmented villonodular synovitis (PVNS) was made from the result of the anatomopathological examination. The patient presented good clinical evolution, with disappearance of symptoms and return to physical activities.

Objetivo: Relatar e discutir o caso de um paciente com tumor de células gigantes da nona vértebra torácica com evolução peculiar. Relato do caso: Paciente com dor torácica radicular, detectada lesão na nona vértebra torácica, foi operado e recebeu diagnóstico anatomopatológico de tumor de células gigantes (TCG). Apresentou três recorrências locais, sendo a primeira manejada com reintervenção cirúrgica em dois tempos, na segunda também foi realizada reintervenção cirúrgica, porém com fenolização do sítio cirúrgico, preenchimento com metilmetacrilato e radioterapia pós-operatória. Apresentou semeadura de tumor retroesternal, o qual foi ressecado cirurgicamente, não tendo sido realizada terapia complementar. Uma terceira recorrência foi detectada durante procedimento de correção de falência da artrodese posterior, sendo realizada ressecção da lesão e quimioterapia pós-operatória. Durante o tratamento, desenvolveu imunossupressão e evoluiu para óbito em decorrência de suas complicações. Conclusão: O TCG acometendo a coluna torácica é pouco frequente. Trata-se de uma lesão benigna, agressiva localmente e com comportamento incerto. A ressecção cirúrgica com margens amplas é o tratamento padrão-ouro, porém nem sempre factível, em decorrência da localização da lesão.

O tumor de células gigantes é uma lesão óssea primária benigna que acomete a epífise de ossos longos, com maior incidência na terceira e quarta décadas de vida, mas que pode apresentar comportamento de um tumor maligno, com metástases à distância. Até dez por cento dos doentes podem apresentar metástases à distância, principalmente para o pulmão, geralmente acompanhadas de recidiva no local primário. O tratamento do tumor primário é a ampla ressecção cirúrgica. Os autores relatam o caso de um doente com 35 anos com metástases pulmonares 21 meses após ter realizado curetagem de tumor de células gigantes em fémur distal.Gian cell is normally a benign primary skeletal lesion located in the epiphysis of the long bones. It is more frequente in the third and fourth decades of life but can exhibit the behaviour of a malignant tumour with distal metatasis. Up to 10% of patients present distal metatasis, usually in the lung, and it is concomitant to recurrence in the primary site. The treatment of primary tumour is extensive surgical resection. We report a case of a 35-year-old patient with lung metatases 21 months after curettage of giant cell tumour in distal femur.

El tumor marrón del hiperparatiroidismo en los maxilares es poco frecuente. Se reporta 1 caso de una paciente tratada quirúrgicamente por lesión osteolítica maxilar. Se describen los antecedentes, la clínica y diferentes exámenes de valor diagnóstico. Se realizó diagnóstico diferencial con el tumor central de células gigantes. Se revisó el tema y se brindaron algunas consideraciones reportadas en la literatura.The maroon tumor of hyperparathyroidism is a rare tumor. The case of a female patient surgically treated due a maxillary osteolytic lesion was reported. The history, clinic and different examinations of diagnostic value are described.. A differential diagnosis was made with the central tumor of giant cells. The topic was reviewed and some considerations reported in literature were made.

Giant cell tumor is a benign and aggressive tumor, it represents approximately among 5 to 9% of totality of primary bone tumors. This tumor appear principally in patients between 20 to 40 years old, the knee is the more common location. The clinic course is unpredictable, The patient can be asymptomatic and we detect the tumor as a radiology discovery or sometimes can present pain and local inflammation whit variable function limitation, sometimes the patients ask for medical attention by the presence of pathologic fracture in the tumor site. The X ray is the basis for the diagnosis. Clinical case: Female patient of 26 years old with a giant cell tumor located in a left proximal humerus, which was treated with tumor resection and placement of a craft prothesis. [ABSTRACT FROM AUTHOR]

The case of a 75 years patient assisted in the Traumatology Department of "Calilo García" Center of Comprehensive Diagnosis with operating room in Apure state, Bolivarian Republic of Venezuela is described who, for 3 years approximately had suffered a traumatism in the dosal size of the left foot, reason why he presented an increase of volume, of relatively slow growth, adhered to deep planes, not painful at deep palpation. The radiographic studies of the foot were normal and in the echography of soft parts, images of not well defined borders were visualized with cellularity inside. The exeresis of the tumor was carried out and the results of the biopsy confirmed that it was a villonodular synovitis. The clinical course was satisfactory and the patient returned to his habitual activities. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Unconventional Computing is the property of Old City Publishing, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

O Tumor de Células Gigantes (TGC), é um tumor benigno, com ocorrência de recidiva em cerca de 20-34% dos casos. A localização habitual é na epífise dos ossos longos. O objetivo deste trabalho é relatar um caso de TGC em vértebra, com diagnóstico inicial de Cisto Ósseo Aneurismático (COA), e discutir os diagnósticos diferenciais possíveis, correlacionando-os com as características dos exames de imagens. Paciente com 37 anos, do sexo feminino, com quadro clínico de dor na coluna e paraparesia há 2 meses. O diagnóstico inicial foi de COA. Na radiografia a lesão era lítica, com, erosão e destruição da cortical..A tomografia e ressonância evidenciavam lesão cística e hemorrágica, com extensão para partes moles. A revisão das lâminas e análise do espécime cirúrgico ressecado, submetido à coloração HE e imunoistoquímica com marcador para p53, permitiram o diagnóstico de TGC. Muitas lesões, benignas apresentam células gigantes multinucleadas. Os exames de imagem nem sempre permitem um diagnóstico conclusivo. O diagnóstico definitivo de TGC depende do exame anatomopatológico, com avaliação cuidadosa do componente estromal e a imunoexpressão positiva para a proteína p53. O tratamento é a ressecção cirúrgica, com margens amplas seguida por instrumentação nos casos de tumor localizados na coluna vertebral.Giant Cell Tumor (GCT) is a benign tumor, with a recurrence rate of about 20% - 34% of the cases. It is usually located at long bone epiphysis. The objective of this study is to report a GCT case in a vertebra, which was early diagnosed as Aneurysmal Bone Cyst (ABC), and to discuss potential differential diagnosis, correlating them to patterns shown on imaging tests. This patient is a 37 year-old female, with clinical picture of pain in spine and paraparesis that started two months earlier. An early diagnosis of ACB was delivered. At X-ray, the injury was lithic, with erosion and cortical destruction. Tomography and resonance showed a cystic and hemorrhagic injury, extending to soft parts. Slides review and the analysis of dried surgical matter submitted to HE and immunohistochemical staining with p53 marker allowed for GCT diagnosis. Many benign lesions present with multi-nucleated giant cells. Imaging tests not always enable a conclusive diagnosis. A definite GCT diagnosis depends on anatomicopathological test, with careful evaluation of the stromal component and positive immunoexpression for p53 protein. Treatment is delivered as surgical resection, with wide margins, followed by instrumentation in cases of tumors located at spine.

The giant cell tumor is a neoplastic entity, locally aggressive and with not predictable behavior. The gianl cell lumor located in head and neck has a very low frequency (less than 2%), therefore when referring that larynx it is implied it has a lower frequency. We report a case of a patient with upper obstructive respiratory symptoms, with incomplete resection of the subglottic lesion, which showed postoperative accelerated growth and which required radical laryngectomy afterwards, due the local aggressive behavior of the tumor. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cirugía Oral y Maxilofacial is the property of Sociedad Espanola de Cirugia Oral y Maxilofacial (SECOM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The authors report the case of a giant cell tumor of the frontal sinus in a 54-year-old male patient. This tumor location is rare, and this is the third case reported in the literature with radiographic documentation and histopathological confirmation. The patient underwent surgery, with curettage of frontal sinus and placement of a prosthesis. He died because a voluntary abrupt discontinuation of corticosteroids. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cirugía Ortopédica y Traumatologia (English Edition) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Soft tissue giant cell tumor is a rare tumor. It occurs mainly in adults, in the lower extremities, and it has not gender predominance. Clinically it has a multinodular aspect and the best therapeutic option is a conservative surgical resection. We describe the case of a 55-year-old man with a multilobullated neoformation that affected the first toe of left foot, with a hystopathological diagnosis of giant cell tumor of soft tissues. The therapy consisted on partial amputation of the affected toe, to remove completely the tumor. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cirugía Oral y Maxilofacial is the property of Sociedad Espanola de Cirugia Oral y Maxilofacial (SECOM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Giant cell tumor (GCT) is one of the most controversial and unpredictable tumors in its clinical behavior. In this study, we report four cases in stage III (highly aggressive), between March 2001 and April 2002, in patients aged between 28 and 55 years. The four patients were from the male sex. In three cases, the right knees were affected and the left knee in just one case. The cases were analyzed according to their clinical behavior, 3 of them were treated through supracondylar amputation and in the other one it was applied a tumor-like-type prosthesis. None of the cases developed metastasis and all of the cases presented a good clinical evolution. We focus the discussion on the treatment of this stage according to the literature reports. [ABSTRACT FROM AUTHOR]

CASO CLÍNICO: paciente femenina de 44 años, que vive en zona urbana, actividad casera y de peso promedio para su talla. Presentómasa en 1/3 proximal de la tibia derecha de 8 meses de evolución, diagnosticándose tumor de células gigantes, manejado concuretaje óseo simple y colocación de injertos óseo autólogo, presentando recaída a los 6 meses. Radiológicamente se observaimagen osteolítica, metaepifisiaria en estadio III de Campanacci. Se confirma diagnóstico con biopsia y se decide llevar a cirugíapara resección amplia, realizar resección en bloque, preservando la extremidad. Se realiza compuesto aloprótesico con prótesistipo COLUMBUS (BRAÜN-AESCULAP) e injerto osteocondral. Este último se colocó inicialmente con reparación ligamentaria, yosteosíntesis con placa; sobre estos modelos se realizó la navegación con el ORTHOPILOT (BRAÜN), navegación computarizadapara lograr un buen alineamiento en los ejes bio-mecánicos. La prótesis utilizada es ultra congruente y la reparación del tendónrotuliano se realizó termino-terminal con CERVISET (3M), con rotación muscular del gastronemio medial. En los controlesposteriores se observó integración del aloinjerto a los seis meses y movilidad articular de 0 a 90 grados, con marcha asistida por unbastón. Al año la paciente tiene aceptable movilidad y no se han presentado complicaciones en la integración del aloinjertomasivo.COMENTARIOS: la característica del tumor de células gigantes es su agresividad local, con la posibilidad de dar metástasis ymalignizarse en un 2%. Por lo anterior su tratamiento debe ser radical. La resección en bloque, tiene la tasa más baja de recaída orecidiva al momento de realizar un salvamento de extremidad. El uso de aloinjertos masivos asociado a componentes protésicosarticulares es una opción de reconstrucción ofreciéndole la posibilidad de una rehabilitación precoz y proporcionando unaestabilidad ligamentaria mucho mejor que un aloinjerto osteocondral y la posibilidad de revisión en caso de falla (en comparacióncon las endoprotesis). El método de navegación durante la cirugía, es una ayuda para lograr una aproximación tridimensional aunos ejes mecánicos y anatómicos bastantes precisos. El uso de navegador en compuestos aloprotésicos no está documentado,existe reporte de procedimientos en revisión de cirugía de rodilla por artrosis con el uso de cuñas para compensar pérdidasmenores de hueso. La técnica no difiere de una cirugía primaria, corrigiendo los cortes irregulares y logrando un balanceligamentario adecuado en el paciente. Las ventajas de los compuestos aloprotésicos motivan aún más a realizar este tipo decirugía. Hay que proveerle un método funcional, duradero y con la posibilidad en caso de complicación tener otras opciones antesde tratamientos radicales.

Copyright of Universidade Estadual Paulista. Revista de Odontologia is the property of Universidade Estadual Paulista. Revista de Odontologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)