Large Giant Cell Tumor of the Proximal Tibia: Therapeutic Management About a Case Report

Introduction and importance: Giant cell tumours account for 4–5% of primary bone tumours. In large tumours affecting the bones of the lower limbs, it can be disabling and thus requires a good therapeutic strategy. We report the clinical case of a voluminous giant cell tumour of the proximal tibia. The aim of this presentation was to explain the aggressive nature of these tumours in young patients and to present the long-term results of surgical management. Case presentation: A 23-year-old patient with no previous pathological history. He was admitted with a giant cell tumour of the proximal left tibia that had been progressing for 16 months and was becoming disabling, with repercussions on socio-professional life. A surgical biopsy confirmed the diagnosis, and the treatment strategy consisted of a wide curettage with filling of the bone defect with acrylic cement. To allow the patient to recover weight bearing, a supportive osteosynthesis was used to restore the patient’s autonomy. After 2 years, the patient was reported to have moderate intermittent pain, with no signs of clinical or radiological recurrence. Clinical discussion: Giant cell tumours are characterized by their benign histological appearance, but present local aggressiveness and have an unpredictable evolution towards recurrence or malignant transformation. They are potentially debilitating to the lower limb in cases of significant bone lysis. Conclusion: Traditional surgical treatment by curettage and filling remains an effective option in the vast majority of cases, but does not provide weight-bearing support in cases of significant bone loss. The use of internal osteosynthesis for reinforcement will enable patients to recover stability and a better quality of life in the short to long term.