Delayed diagnosis May lead to giant cell tumor of bone progression

Giant Cell Tumor of Bone is an intermediate, locally aggressive tumor that is often diagnosed at an advanced stage due to diagnostic delays. Hypothetically, diagnostic delays may result in advanced disease, necessitating more invasive surgery and causing significant lifelong burden. This systematic review explores the available literature on diagnostic and treatment delays in Giant Cell Tumor of Bone. A systematic review was conducted using the Medline, Embase, and Cochrane databases on February 9, 2023. A total of 15 studies representing 34 cases (32 cases analyzed) were included after thorough review and critical appraisal. Fifteen articles representing 32 cases were included. The median age of the included cases was 29 years (IQR 24-41). Tumor locations included the foot (22%), spine (19%), distal ulna (16%), and other sites (43%). Campanacci grades 2 and 3 (used to assess tumor severity) were reported in 16% and 81% of cases, respectively. Primary GCTB accounted for 88% of cases, while 12% involved local recurrence. The median diagnostic delay was 5.5 months (IQR 3.0-13.5). Patient-related delays (13 cases) had a median of 6 months (IQR 3-35), referral delays (19 cases) had a median of 4 months (IQR 3-12), and diagnostic delays (4 cases) had a median of 2.5 months (IQR 1-4). Diagnostic delays in Giant Cell Tumor of Bone were identified, and were often associated with advanced disease. Further research involving a larger number of cases is essential to assess the impact of these delays on clinical outcomes and disease progression.