GIANT-CELL TUMOR OF BONE IN THE FOOT AND ANKLE

Giant cell tumor of bone has been shown to behave more aggressively wh en located in the wrist and hand. Although nearly 4% of giant cell tum ors arise in the foot and ankle, biological features specific to this location have not been identified, In our experience with more than 30 0 cases of giant cell tumor, 12 arose in the foot and ankle and were f ollowed for more than 2 years. These included nine females and three m ales ranging in age from 15 to 52 years (mean age, 29.5 years), All pa tients presented with pain of 5.0 months' mean duration and 9 of 12 tu mors demonstrated aggressive radiographic features, including bone ero sion and destruction; five had either invasion of a joint or a soft ti ssue mass present, Unlike the hand, where metacarpal and phalangeal le sions are common, no tumors arose in the forefoot and nine of the tumo rs were present in the ankle region. Four patients were treated with r esection (no recurrence), two with curettage and cement packing (one r ecurrence), and six with curettage and autologous bone graft (two recu rrences), which resulted in an overall recurrence rate of 25%. None of the recurrent tumors have returned after additional treatment, which consisted of curettage and cement packing in two cases and resection i n one case, Five tumors (four primary, one recurrent) were treated wit h local resection and reconstruction with no major complications and w ith no amputations performed. Thus, giant cell tumors of the foot and ankle can be treated with local procedures, which result in recurrence rates similar to those found in more common locations.