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A giant cell tumor is one that is made up of a large number of benign (noncancerous) cells that form an aggressive tumor, usually near the end of the bone near a joint. The location of a giant cell tumor is often in the knee, but can also involve the bones of the arms and the legs, or the flat bones such as the sternum (breastbone) or pelvis.
Giant cell tumors most often occur in young adults when skeletal bone growth is complete. Most occur in the long bones of the legs and arms.
While the exact cause of giant cell tumors remains unknown, in some cases, they have been linked to Paget disease. Paget disease of the bone is a chronic bone disorder in which bones become enlarged and deformed.
The following are the most common symptoms of a giant cell tumor. However, each individual may experience symptoms differently. Symptoms may include:
Pain at the nearest joint
A visible mass
Limited movement in the nearest joint
Fluid accumulation in the joint nearest the affected bone
The symptoms of a giant cell tumor may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.
In addition to a complete medical history and physical examination, diagnostic procedures for giant cell tumors may include the following:
X-rays. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film.
Radionuclide bone scans. A nuclear imaging method used to evaluate any degenerative and/or arthritic changes in the joints, to detect bone diseases and tumors, and to determine the cause of bone pain or inflammation.
Biopsy. A procedure in which tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope to determine if cancer or other abnormal cells are present.
Specific treatment for giant cell tumors will be determined by your doctor based on:
Your age, overall health, and medical history
Extent of the disease
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference
The goal for treatment of a giant cell tumor is to remove the tumor and prevent damage to the affected bone. Treatment may include:
Surgery to remove the tumor and any damaged bone
Bone grafting. A surgical procedure in which healthy bone is transplanted from another part of the patient's body into the affected area.
Amputation may be required in severe cases
Physical therapy to regain strength and mobility
Tumors that cannot be removed surgically can often be controlled and sometimes destroyed with radiation therapy. New therapies are being sought for giant cell tumors of bone, and recent clinical trials of the drug Denosumab have been promising. For unresectable tumors, ask your doctor about clinical trials.
Giant cell tumors can recur. Follow-up with a doctor may be required for several years.
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