大腿骨頚部に生じた骨巨細胞腫の検討

概要

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Giant cell tumor of bone (GCT) is known for its extremely high recurrence rate among bone tumors, and if it arises primarily at the femoral neck, particular attention must be paid. We studied primary GCT at the femoral neck in 8 patients, which was difficult to diagnose and treat in 8 patients treated between 1990-2001. The patients, 7 men and 1 woman,were first diagnosed with GCT at mean age of 31 years rage, 19-73 years, and followed up for a mean period of mean 80.0 months range, 24-156 months. One patient had preoperative open biopsy, and the remaining 7 patients had excisional biopsy, to decide the treatment method after rapid pathological examination during the surgery. The initial surgical method was total hip arthroplasty (THA) in 2 patients, bipolar hip arthroplasty (BHA) in 1 patient, curettage with open reduction internal fixation (ORIF) in 2 patients, curettage and cementing in 2 patients, and the arthrodesis of the hip joint in 1 patient. Local recurrence was observed in 2 patients who underwent the curettage and cementing. GCT is a borderline bone tumor, THA and BHA should be avoided for the initial surgery, as they can be feasible later. The initial surgical method should be excisional or incisional biopsy, taking precedence of the method to allow the recovery surgery, even though the altimate diagnosis is malignant GCT.
中国・四国整形外科学会の論文