A rare occurrence of distal fibular giant cell tumor in adolescent: a case report


  • Yogi Ismail Gani Resident, Department of Orthopaedic and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital
  • Yogi Prabowo Oncology Consultant, Department of Orthopaedic and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital




Giant cell tumor, distal fibula, excision, reconstruction



Most Giant Cell Tumors appear at epiphyseal area, predominantly at knee area or wrist. It is usually affecting people around the third to fourth decades, rarely below the twenties or above the sixties. The mainstay of treatment is surgery, purposely to eliminate the tumor, restore the function as near to normal. Diagnosis can be made by clinical, radiological decision and histopathology, yet the only gold standard is histopathology.


We present a rare case of giant cell tumor on the right distal fibula, in a female of eighteen years old. The clinical and radiological appearances were not pathognomonic, ultimately needing a biopsy to finally confirm it was a giant cell tumor indeed. A curettage was done, whilst the defect filled with bone substitutes and supported by a plate.


Histopathology study after the surgery revealed the tumor was indeed a giant cell tumor, in accordance to microscopic and macroscopic findings. The patient was advised to not weight-bear for another 3 months, and partial weight-bear for the next 6 until 12 months. Diagnosing a giant cell tumor might be challenging, especially if the symptoms are not obvious, epidemiologically inconclusive, and radiologically insatiable. A biopsy will be needed, but a coherence with clinical judgement is advised. Finally, the proposed excision and reconstruction options should coincide with the need of functionality of the patient.


Given certain circumstances, it is hard to diagnose a giant cell tumor. A careful approach should be kept in mind, malignancy should be ruled out as soon as possible.


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Skubitz KM. Giant cell tumor of bone: current treatment options. Curr Treat Options Oncol. 2014;15(3):507–18.

Siddiqui MA, Seng C, Tan MH. Risk factors for recurrence of giant cell tumours of bone. J Orthop Surg. 2014;22(1):108–10.

Jamshidi K, Mazhar FN, Masdari Z. Reconstruction of distal fibula with osteoarticular allograft after tumor resection. Foot Ankle Surg [Internet]. 2013;19(1):31–5. Available from: http://dx.doi.org/10.1016/j.fas.2012.09.001

Lee SH, Kim HS, Park YB, Rhie TY, Lee HK. Prosthetic reconstruction for tumours of the distal tibia and fibula. J Bone Jt Surg - Ser B. 1999;81(5):803–7.

Nadkarni S, Punit AS, Nair R V. Giant Cell Tumour of Distal Fibula Managed by En Block Resection and Reconstruction with Ipsilateral Proximal Fibula. J Orthop case reports. 2015;5(1):52–524.

Eger W, Schörle C, Zeiler G. Giant cell tumor of the distal fibula: Fifteen-year result after en bloc resection and fibula reconstruction. Arch Orthop Trauma Surg. 2004;124(1):56–9.

Scaglioni MFC, Arzi RY, Gur E, Amotz O Ben, Barnea Y, Kollender Y, et al. Free fibula reconstruction of distal tibial defects after sarcoma surgery. Ann Plast Surg. 2015;74(6):680–3.

Myers GJC, Abundu AT, Carter SR, Tillman RM, Grimer RJ. Endoprosthetic replacement of the distal femur for bone tumours. J Bone Jt Surg - Ser B. 2007;89(4):521–6.

Kundu ZS, Gogna P, Gupta V, Singla R, Sangwan SS, Mohindra M, et al. Ankle fusion with centralisation of the fibula after distal tibia bone tumour resection. J Orthop Traumatol. 2014;15(2):95–101.

Campanacci DA, Scoccianti G, Beltrami G, Mugnaini M, Capanna R. Ankle arthrodesis with bone graft after distal tibia resection for bone tumors. Foot Ankle Int. 2008;29(10):1031–7.

Vaishya R, Kapoor C, Golwala P, Agarwal AK, Vijay V. A Rare Giant Cell Tumour of the Distal Fibula and its Management. Cureus. 2016;8(7):1–7.

Schwab JH, Mankin HJ, Springfield DS. Giant Cell Tumor of Bone Abstract. :118–26.

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