Working Diagnosis:
Giant Cell Tumor of Bone in the Right Distal Femur

Treatment:
The patient underwent curettage of the right distal femur lesion, bone grafting, cementation, and internal plate fixation with orthopedics and orthopedic oncology.

Outcome:
She had no postoperative complications. In the postoperative period, she was non-weight-bearing for 21 weeks. She was able to progress to partial weight-bearing for 6 weeks with physical therapy and then to full weight-bearing about 6 months postoperatively. She completed the return-to-dance protocol of gait training and hip and quadricep rehabilitation. She has advanced in dance classes. She continues to avoid catwalk or ladder activities.

Author's Comments:
Giant cell tumors of bone most commonly affect patients ages 20 to 40 years. These tumors are typically benign but can metastasize in about 1-9% of patients. The most common location is the distal femur, followed by the proximal tibia, distal radius, and sacrum. Presenting symptoms are often nonspecific and include pain, swelling, and limited range of motion. The recommended initial imaging is radiographs. On radiographs, giant cell tumors of the bone appear as osteolytic or radiolucent lesions with a well-defined, non-sclerotic margin. MRI or CT may be needed for further characterization. A tissue biopsy is necessary to confirm the diagnosis and tumor grading. The treatment of choice for giant cell tumors of the bone is surgical treatment with removal by resection or curettage, with or without chemical or physical adjuvants.

Editor's Comments:
This is a classic case of a giant cell tumor of the bone. Giant cell tumors are rare, comprising approximately 4-5% of primary bone neoplasms. Giant cell tumors of the bone are typically found at the end of the long bones and occur after the growth plate is closed. These are often locally aggressive, although malignant transformation is rare (

References:
Sobti A, Agrawal P, Agarwal M. (2016). Giant Cell Tumor of Bone - An Overview. The archives of bone and joint surgery, 4(1), 2-9.

Mavrogenis AF, Igoumenou VG, Megaloikonomos PD, Panagopoulos GN, et al. (2017). Giant cell tumor of bone revisited. SICOT-J, 3, 54. https://doi.org/10.1051/sicotj/2017041

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