Giant cell tumor of bone Treatment
Treatment of giant cell tumor of bone mainly is surgery, the use of inactivated curettage treatment, implantation of autologous or allogeneic cancellous bone or bone cement, but easy to relapse. If the relapse, should be removed or cut away segment or sham surgery implant surgery. Wide or radical resection, chemotherapy does not work, on the surgery difficulties occurred in parts such as spinal, should use radiotherapy.
1. local excision. Such as partial resection of lesions have little effect on the function, preferably completely removed, such as Charcot-Marie-top, the lower end of ulna, radius top, hand, foot and other bones.
2. a thorough curettage, 50% zinc chloride cautery plus bone grafting. Adjacent to large joints of the benign giant cell tumor of bone, such as bone grafting method using simple curettage, the recurrence rate can be as high as 40 ~ 70%, so destructive of many scholars to take major surgery, such as together with the articular surface with segmental resection for tumor, and then to the body or artificial bone and joint replacement, the law and more complications such as nonunion, joint stiffness, prosthesis loosening, infection, can cause serious disability and even lead to amputation. In fact, the so-called recurrence, surgery is not completely caused by curettage, in order to reduce recurrence, we have devised the following method: appropriate exposure to tumor site, a thorough curettage under direct vision in tumor tissue, and then to 50% zinc chloride Zhou and cautery bone wall, to kill residual tumor cells by using normal saline thoroughly under running water, the use of autologous cancellous bone graft. Experiments show that 50% of zinc chloride has a strong penetrating power and can kill 5 mm deep in the tumor cells, as well as no adverse effects on bone healing, the bone shell after curettage is still a good blood supply, and ensure the bone healing. In addition, the normal joint and soft tissue around the attachment without any impact on postoperative function of the joint guarantee. Since 1964, the method to deal with 130 cases of giant cell tumor of bone, the recurrence rate decreased to 10%, the recurrence of individual cases were dealt with using the same method will still have the cure.
3. resection or amputation. Such as the vicious, the larger the scope, there are soft tissue infiltration or recurrence should be considered on the basis of specific local excision or amputation, and some loss of joint after tumor resection, such as the neck, could be considered after resection Application of artificial joints or arthrodesis.
4. radiotherapy. In the operation easy to achieve, or the removal after the function is too large, such as vertebral giant cell tumor of bone, may wish to consider radiation therapy, the dose must be adequate. Have a certain effect, a small number of patients with malignant transformation can occur after irradiation. By surgery or radiation therapy patients, it is necessary to long-term follow-up, pay attention to whether local recurrence and lung metastasis of malignant change.