Giant Cell Tumor of the Proximal Fibula With Common Peroneal Nerve Neuropraxia

Giant cell tumor (GCT) is among the commonest benign tumors and represents 5% of bone neoplasms. It is more common in young adults aged between 20 and 40 years. The distal femur is one of the most common sites, with the proximal tibia and distal radius the next frequently involved site, respectively. Previous research indicates that the tumor is an uncommon occurrence at this given age and location. Surgical management is the primary treatment for GCT universally. Extended curettage with the use of an argon beam cauterizer, a power burr, bone cement, hydrogen peroxide, phenol, liquid nitrogen, and zinc chloride are some of the treatment modalities for GCT. Opting for appropriate surgical treatments plays a crucial role to reduce the rate of recurrence and improve functional and oncological outcomes. In this case study, a 55-year-old male was diagnosed with GCT of the head of the right fibula with foot drop. The patient was managed with wide excision of the tumor and anchoring of lateral collateral ligament and biceps femoris to medial tibia condyle followed by postoperative galvanic stimulation for common peroneal nerve neuropraxia and guarded weight-bearing mobilization with bracing for knee joint. After 12 months of follow-up, there is no evidence of recurrence with a stable knee joint and dorsiflexion of the right ankle up to the neutral position.

[1]  I. G. M. Putra,et al.  Functional outcome in patient with giant cell tumour distal radius after reconstruction by en-bloc resection and non-vascularized fibular bone graft: a case report , 2020, International Journal of Research in Medical Sciences.

[2]  O. Jesus,et al.  Giant Cell Tumor , 2020, Definitions.

[3]  Arif Ali,et al.  Treatment and recurrence of giant cell tumors of bone – A retrospective cohort from a developing country , 2019, Annals of medicine and surgery.

[4]  Can Zhang,et al.  Surgical Treatment Options for Giant Cell Tumors of Bone Around the Knee Joint: Extended Curettage or Segmental Resection? , 2019, Front. Oncol..

[5]  S. Pandey Giant Cell Tumor Arising from Fibular Head in Immature Skeleton Treated with Marginal Excision , 2018, Journal of College of Medical Sciences-Nepal.

[6]  O. Zaikova,et al.  Giant Cell Tumor: A Rare Condition in the Immature Skeleton—A Retrospective Study of Symptoms, Treatment, and Outcome in 16 Children , 2016, Sarcoma.

[7]  Yingze Zhang,et al.  Recurrence Rates and Risk Factors for Primary Giant Cell Tumors around the Knee: A Multicentre Retrospective Study in China , 2016, Scientific Reports.

[8]  Tessa Gordon,et al.  Electrical Stimulation to Promote Peripheral Nerve Regeneration , 2016, Neurorehabilitation and neural repair.

[9]  Qing-cheng Yang,et al.  Factors Affecting the Recurrence of Giant Cell Tumor of Bone After Surgery: A Clinicopathological Study of 80 Cases from a Single Center , 2015, Cellular Physiology and Biochemistry.

[10]  Javed Jameel,et al.  Giant Cell Tumor Bone in an Elderly Male- an Unusual Case Misdiagnosed on MRI as a Malignant Sarcoma , 2015, Indian Journal of Surgical Oncology.

[11]  H. Gelderblom,et al.  The clinical approach toward giant cell tumor of bone. , 2014, The oncologist.

[12]  V. Krenn,et al.  Multicentric Giant Cell Tumor of Bone: Synchronous and Metachronous Presentation , 2013, Case reports in orthopedics.

[13]  F. Sim,et al.  Giant Cell Tumor of Bone: Risk Factors for Recurrence , 2011, Clinical orthopaedics and related research.

[14]  Manish Agarwal,et al.  Treatment of giant cell tumor of bone: Current concepts , 2007, Indian journal of orthopaedics.

[15]  M. Werner Giant cell tumour of bone: morphological, biological and histogenetical aspects , 2006, International Orthopaedics.

[16]  K. Dominic,et al.  Extended curettage and reconstruction with proximal fibula for treating giant cell tumor of lateral femoral condyle: A prospective study , 2017 .

[17]  M. Agarwal,et al.  Giant Cell Tumor of Bone - An Overview. , 2016, The archives of bone and joint surgery.