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