How is a giant cell tumor treated?
Treatment of a giant cell tumor may involve one or a combination of the following surgical procedures performed by a pediatric orthopedic surgeon:
- Curettage - This is the most common form of treating a giant cell tumor. Curettage is an operation during which the tumor is scraped out of the bone.
- For this procedure, surgeons make an incision in the bone to create a window to expose the entire tumor. The tumor is then completely removed.
- Cryotherapy - This may be used to supplement curettage. Surgeons fill the cavity that remains after curettage with liquid nitrogen to freeze the area. It's then thawed out and may be frozen again. The freeze and thaw cycle, which would help prevent any missed remnants of the tumor from growing, is repeated once or twice.
- Bone grafting or cement packing - Sometimes the remaining cavity is packed with donor bone tissue (allograft), bone chips taken from another bone (autograft), or other materials, including bone cement (the same material used in total joint replacements), depending on the preference of the surgeon.
- En bloc resection - For more aggressive tumors, the operation will likely involve en bloc resection, which is the surgical removal of bone containing the tumor, rather than curettage.
- Internal fixation, with pins, may be required to restore the structural integrity of the bone.
If significant bone loss results, allograft transplants or metallic replacements are used to reconstruct the bone. Although common in the past, this aggressive procedure is not commonly used as the initial treatment today.
What's my child's long-term outlook?
Generally speaking, these tumors can be treated successfully and the long-term prognosis is good. These tumors can, however, recur. Prompt medical attention and aggressive therapy are important for the best prognosis.
Continual follow-up care is essential for a child diagnosed with a giant cell tumor. It's rare to see the tumors spread to the lung is rare, but your child will be monitored periodically with chest x-rays and sometimes CT scans to look for the occurrence of lung lesions.
What is the recommended long-term care for children treated for giant cell tumors?
Your child should visit a survivorship clinic every year to:
- manage disease complications
- screen for early recurrence of cancer
- manage late effects of treatment
A typical follow-up visit may include some or all of the following:
- a physical exam
- laboratory testing
- imaging scans
Through the David B. Perini, Jr. Quality of Life Clinic at Dana-Farber Cancer Institute, childhood cancer survivors receive a comprehensive follow-up evaluation from their cancer care team.
- Our childhood cancer survivorship clinic is held weekly.
- In addition to meeting with your pediatric oncologists, your child may see one of our endocrinologists, cardiologists, neurologists, neuro-psychologists or alternative/complementary therapy specialists.
We also offer the following services:
- patient and family education
- psychosocial assessment
- genetic counseling
- reproductive and fertility evaluation and counseling
- opportunities to speak with other childhood cancer survivors