Giant cell tumour (GCT) of bone is a rare, usually noncancerous but aggressive tumour that develops in adults after skeletal growth has been completed, most often between the ages of 20 and 40. It is slightly more common in women and typically grows near the ends of long bones, particularly around the knee, but may also affect bones of the arms, legs, pelvis, or breastbone. Although benign, giant cell tumours can grow quickly, damage bone, and impair joint function, making timely diagnosis and treatment important.
Causes and Risk Factors
GCT has been linked to Paget’s disease of bone, a chronic condition where bones become enlarged and deformed. While not hereditary in most cases, the occurrence of GCT may be influenced by underlying bone disorders that alter normal bone growth and repair processes.
Symptoms
The signs and symptoms of a giant cell tumour vary depending on its size and location. Common features include swelling, pain near the affected joint, and restricted movement. Some patients may notice a visible lump or experience a fracture in the weakened bone. Fluid build-up in the nearby joint can further limit motion and cause discomfort. Because these symptoms overlap with other musculoskeletal conditions, proper medical evaluation is essential for accurate diagnosis.
Diagnosis
Diagnosing a giant cell tumour requires a combination of clinical evaluation and imaging studies. Physicians typically begin with a detailed history and physical examination, followed by imaging tests such as X-rays, CT scans, or MRIs to determine the extent of the tumour and bone involvement. A radionuclide bone scan may be used to detect bone activity and rule out infection or fractures. The definitive diagnosis is usually made through a biopsy, in which a tissue sample is examined under a microscope to confirm the presence of giant cells.
Treatment Options
The primary goal of treatment is to remove the tumour while preserving as much bone and joint function as possible. Surgery is the most common approach, often combined with bone grafting or reconstruction to restore stability. Physical therapy is usually recommended afterward to improve mobility and strength. In rare, severe cases where the tumour cannot be managed, amputation may be required. Radiation therapy may be considered when surgery is not feasible, though tumours treated this way require careful follow-up. Because GCTs have a tendency to recur, long-term monitoring is essential.
Giant cell tumour of bone, while noncancerous, is a fast-growing condition that can lead to significant bone damage and joint complications if untreated. With advances in surgical techniques and rehabilitation, most patients achieve good outcomes. However, due to the risk of recurrence, ongoing follow-up care remains a critical part of management.
