Giant Cell Tumor (Osteoclastoma): Surgical Therapy

The location and extent of giant cell tumor (osteoclastoma) usually require intralesional resection (excision):

• Procedure: Opening of the tumor → curettage → filling of the bone defect initially with bone cement → Advantage: The tumor cells of the marginal zones are killed by the polymerization heat of the cement. Recurrences (recurrence of the disease) at the bone/cement interface can thus be diagnosed more easily. If the patient is one to two years free of recurrence, the bone cement can be removed again and replaced by autologous (from the patient himself) Spongiosa (internal, bony network of bone substance).
• In addition to bone cement, the following other additional adjuvants (effect enhancers) that contribute to a lower recurrence rate have been shown to be effective:
  • Mechanical adjuvants: high-speed milling – Through them, a thermal resection margin expansion is achieved.
  • Physicochemical adjuvants: phenol, alcohol, cryosurgery (kyrotherapy; icing), cauterization (destruction of tissue by a cauterizing iron or cauterizing agent).

To ensure the stability of the bone, after surgery, the bone can be fixed using composite plates (osteosynthesis).

Large tumors may require segmental resection followed by bone implants or tumor endoprostheses.

In cases of giant cell tumor close to the joint, resection may require joint replacement.