medigraphic.com
ISSN 1561-3100 (Print)

2013, Number 2

<< Back Next >>

Revista Cubana de Ortopedia y Traumatología 2013; 27 (2)

Giant-cell tumor of the fibula and common peroneal nerve palsy

Peña ML, Mohammad HH, López DH, Al-Dhubiani M, Al-Nozily KA, Ghani GAA

Language: Spanish
References: 25
Page: 209-218
PDF size: 85.91 Kb.


ABSTRACT

Tumors of the fibula constitute a mere 2.5 % of the primary tumors of bone, and only one third of them are benign. Giant-cell tumors are a benign lesion, but their behavior may be locally aggressive. This case presentation is aimed at describing the successful treatment of a giant-cell tumor. A 30-year-old male patient with an imaging and histological diagnosis of a giant-cell tumor of the proximal end of the fibula presents with compressive common peroneal nerve palsy. En bloc resection of the proximal end of the fibula and release of the peroneal nerve were performed. The tumor was large. Though there was no infiltration into the neighboring soft tissues, cortical rupture had already occurred. Thus, the tumor was classified as grade III. After two months of rehabilitation, mobility and stability of the knee were normal. Nerve function was recovered 5 months after surgery. At 15 months there were no clinical or imaging signs of tumor recurrence. Grade III classification and location were the two criteria leading to the choice of en bloc resection. This surgical technique enables extraction of the tumor without excessive traction tension on the common peroneal nerve. The patient has fully reintegrated to his work and personal life.


REFERENCES

  1. Gupta R, Seethalakshmi V, Jambhekar NA, Prabhudesai S, Merchant N, Puri A. Clinicopathologic profile of 470 giant cell tumors of bone from a cancer hospital in western India. J Diagn Pathol. 2008;12:239-48.

  2. Campanacci M, Baldini N, Boriani S, Sudanese A. Giant-cell tumor of bone. J Bone Joint Surg [Am]. 1987;69:106-14.

  3. Sung HW, Kuo DP, Shu WP, Chai YB, Liu CC, Li SM. Giant-cell tumor of bone: Analysis of two hundred and eight cases in Chinese patients. J Bone Joint Surg [Am]. 1982;64:755-61.

  4. Wülling M, Engels C, Jesse N. The nature of giant cell tumor of bone. J Cancer Res Clin Oncol. 2001;127:467-74.

  5. Unni KK, Inwards CY. Dahlin's Bone Tumors: General Aspects and Data on 10,165 Cases. Philadelphia, PA: Lippincott Williams & Wilkins 6; 2010.

  6. Abdel MP, Papagelopoulos PJ, Morrey ME, Wenger DE, Rose PS, Sim FH. Surgical Management of 121 Benign Proximal Fibula Tumors. Clin Orthop Relat Res. 2010;468:305-62.

  7. O'Keefe RJ, O'Donnell RJ, Temple HT, Scully SP, Mankin HJ. Giant cell tumor of bone in the foot and ankle. Foot Ankle Int. 1995;16:617-23.

  8. Traibi A, Boulahya A, Ihrai H, Oukabli M, Kabiri EH. Giant cell tumors that originated in the sternum. Gen Thorac Cardiovasc Surg. 2011;59:148-51.

  9. Shena CC, LIa H, Shi ZL, Tao HM, Yang ZM. Current Treatment of Sacral Giant Cell. J Internat Med Res. 2012;40:415-25.

  10. Unni KK. Dahlin's Bone Tumors: General Aspects and Data on 11,087 Cases. Philadelphia, PA: Lippincott-Raven; 1996.

  11. Faezypour H, Davis AM, Griffin AM, Bell RS. Giant cell tumor of the proximal fibula: surgical management. J Surg Oncol. 1996;61:347.

  12. Doga AS, Kulkari SS, Bhosale PB. Distal fibular giant cell tumor. J Postgrad Med. 1995;41:834.

  13. Jowett AJL, Johnston JFA, Gaillard F, Anderson SE. Lateral meniscal cyst causing common peroneal palsy. Skeletal Radiology. 2008;37(4):351-5.

  14. Abdel MP, Papagelopoulos PJ, Morrey ME, Inwards CY, Wenger DE, Rose PS, Sim FH. Malignant Proximal Fibular Tumors: Surgical Management of 112 Cases. J Bone Joint Surg Am. 2012;94(22):165.

  15. Yoo JH, Min KD, Kim CK, Cha JG. A case of extension loss of great toe due to peroneal nerve compression by an osteochondroma of the proximal fibula. Arch Orthopaedic Trauma Sur. 2010;130 (9):1071-5.

  16. Seki N,Okada K, Miyakoshi N, Shimada Y, Itor E. Common peroneal nerve palsy caused by parosteal lipoma of the fibula. J Orthop Sic. 2006;11:88-91.

  17. Lau CP, Huang L, Tsui SK, Ng PK, Leung PY, Kumta SM. Pamidronate, farnesyl transferase, and geranylgeranyl transferase-I inhibitors affects cell proliferation, apoptosis, and OPG/RANKL mRNA expression in stromal cells of giant cell tumor of bone. J Orthop Res. 2011;29(3):403-13.

  18. Emori M, Kaya M, Sasaki M, Wada T, Yamaguchi T, Yamashita T. Pre-operative selective arterial embolization as a neoadjuvant therapy for proximal humerus giant cell tumor of bone: radiological and histological evaluation. Jpn J Clin Oncol. 2012;2(9):851-5.

  19. Klenke FM, Wenger DE, Inwards CY, Rose PS, Sim FH. Recurrent Giant Cell Tumor of Long Bones. Analysis of Surgical Management. Clin Orthop Relat Res. 2011;469:1181-7.

  20. Marcove RC, Sheth DS, Brien EW, et al. Conservative surgery for giant cell tumors of the sacrum.The role of cryosurgery as a supplement to curettage and partial excision. Cancer. 1994;74:1253-60.

  21. Lackman RD, Hosalkar HS, Ogilvie CM, et al. Intralesional curettage for grades II and III giant cell tumors of bone. Clin Orthop Relat Res. 2005;438:123-7.

  22. Erler K, Demiralp B, Ozdemir MT, Basbozkurt M. Treatment of proximal fibular tumors with en bloc resection. Knee. 2004;11:489-96.

  23. Saini R, Bali K, Bachhal V, Mootha AK, Dhillon MS, Gill SS. En bloc excision and autogenous fibular reconstruction for aggressive giant cell tumor of distal radius: a report of 12 cases and review of literature. J Orthopaedic Sur Res. 2011;6:14.

  24. Draganich LF, Nicholas RW, Shuster JK, Sathy MR, Chang AF,Simon MA. The effects of resection of the proximal part of the fibula on stability of the knee and on gait. J Bone Joint Surg Am. 1991;73:575-83.

  25. Szendröi M: Giant-cell tumour of bone. J Bone Joint Surg Br. 2004;86(1):5-12.




2020     |     www.medigraphic.com