bubble_chart Overview

Giant cell tumor of bone, also known as giant cell tumor of bone, is primarily composed of multinucleated giant cells and smaller spindle-shaped or round stromal cells. The giant cells are very large and contain numerous nuclei, sometimes ranging from dozens to over a hundred. The morphology, distribution, and arrangement of the spindle-shaped or round stromal cells are the main basis for determining the nature of the giant cells. Generally, it is classified as...

bubble_chart Diagnosis

1. Jaw bone swelling and facial deformity, with no early subjective symptoms and slow growth.

2. When the alveolar bone is involved, there may be tooth loosening and malocclusion.

3. X-ray films show soap bubble-like or honeycomb cystic shadows accompanied by bone expansion.

﹝Auxiliary Examination﹞

1. For cases with typical clinical manifestations and a confirmed preoperative diagnosis, the examination items are mainly limited to the "A" examination framework.

2. For cases with atypical clinical manifestations, difficult differential diagnosis, large tumors closely related to surrounding critical structures, or suspected malignancy, the examination items may include the "B" and "A" examination frameworks. For malignant giant cell tumor of bone, MRI can be used to detect cervical lymph node metastasis.

1. Jaw bone swelling and facial deformity with slow growth.

2. Tooth loosening and malocclusion.

3. X-ray films show soap bubble-like or honeycomb cystic shadows accompanied by bone expansion.

4. Confirmed by pathological examination.

bubble_chart Treatment Measures

Treatment Measures

Surgical treatment is the primary approach, and intraoperative frozen section examination is required to determine the nature of the lesion. Grade I giant cell tumor: Curettage followed by cauterization of the base or tumor resection within healthy tissue. Grade II or III giant cell tumor: Segmental or partial resection of the jawbone, with immediate bone grafting for reconstruction if necessary.

For general surgical prophylaxis, sulfonamides (e.g., compound formula co-trimoxazole) or drugs primarily effective against Gram-positive bacteria (e.g., erythromycin, penicillin) are selected. For extensive surgeries involving bone grafting or complex reconstruction, combination therapy is typically used, such as: drugs effective against Gram-positive bacteria (e.g., penicillin) + drugs effective against Gram-negative bacteria (e.g., gentamicin) + drugs effective against anaerobic bacteria (e.g., metronidazole). For severe pre- or postoperative infections or large, complex surgical wounds, effective antibiotics can be chosen based on clinical evaluation and drug sensitivity testing.

Giant cell tumor of bone can be classified as benign or malignant based on its histopathological features. Regardless of its nature, surgical treatment is the first choice. Surgery not only removes the lesion but also allows pathological examination of the excised tissue to confirm the tumor's nature, guiding further treatment. Relying solely on topical or oral medications to eliminate the lesion is not advisable. Clinically, many cases have lost treatment opportunities due to delayed surgery, which warrants serious attention.

Cure Criteria

1. Cured: After treatment, the original follicular tumor and metastatic sources have been completely removed or disappeared, and the wound has largely healed.

2. Improved: After treatment, the tumor has shrunk, and symptoms have alleviated.

3. Not cured: After treatment, the tumor shows no reduction, and symptoms remain unchanged.