GIANT-CELL TUMOR OF BONE - PROGNOSIS AND TREATMENT OF PULMONARY METASTASES

Giant cell tumor of bone is a challenging clinicopathologic entity, De spite its benign designation, it has the capacity to recur locally and develop rare pulmonary metastases, Between 1945 and 1991, 104 patient s with histologically benign giant cell tumors of bone, 5 of which met astasized to the lung, were treated at the authors' institution, In th ese cases, histologic materials from the lung were identical to those found in the primary bone lesion, The primary bone lesions were treate d with local curettage (3), wide resection (1), and wide resection wit h prosthesis placement (1), The patients were observed for a mean of 1 2.6 gears (range, 5-38 years), Four of the 5 patients experienced loca l recurrences (average time interval, 34 months), with 3 patients expe riencing 2 or more recurrences, The average time to lung metastasis wa s 23 months; 1 patient presented initially with pulmonary findings, Fo ur patients underwent surgical resection of pulmonary metastases, All 4 patients are alive with no disease progression, despite incomplete p ulmonary resections in 2 patients. Locally aggressive disease and mult iple recurrences appear to be risk factors for pulmonary metastases in benign giant cell tumor of bone, Pulmonary metastases occurred within the first few years after discovery of primary bone tumors, Radiograp hs and computed tomographs of the chest are recommended to rule out th is complication in patients with local recurrences, Resection of pulmo nary metastasis is recommended, Long term survival is not incompatible with persistent pulmonary lesions.