Evolution of a case of multicentric giant cell tumor over a 23-year period.

Abstract

A 17-year-old girl had a multicentric giant cell tumor originating in the sphenoid and sella turcica that was observed for 23 years. During the first 12 years, the same lesion also appeared in the right proximal tibia and left distal radius. Curettage of the tibial lesion and packing with processed bovine bone were followed by a chronic osteomyelitis with continued intermittent wound drainage. Curettage of the radial lesion and packing it initially with autogenous iliac bone graft and subsequently with methylmethacrylate bone cement were followed by local recurrences. The radial lesion eventually was eradicated by a segmental resection of the distal radius. The resulting bony defect was bridged with a bicortical autogenous iliac graft and stabilized with a bone plate to produce a painless solid wrist fusion. No further tumor recurrence has been noted for the past two years.