A 29-year-old female presented after prior treatment for a multicentric, giant cell tumor of the distal, lateral talus and distal tibia with complaints of pain about the knee with articulation with her prosthesis.
Screening x-rays demonstrated generalized osteopenia of the remaining portion of the tibia with a poorly-marginated, radiolucent lesion in the medial tibial plateau. Tomograms demonstrated a multi-lobular pattern of the radiolucent lesion. Isotope scanning demonstrated increased uptake corresponding with the radiographic extent of the lesion.
An incisional biopsy confirmed the diagnosis of multicentric, giant cell tumor, and an above-knee amputation was done. Examination of the gross and microscopic material demonstrated the characteristics of a multicentric, giant cell tumor.
At last follow up, twelve years following her above-knee amputation, there have been no further lesions.
[X-Ray] AP radiograph of the remaining portion of the proximal tibia at presentation.
[X-Ray] Tomogram of the proximal tibia at presentation.
[Iso-Scan] Regional isotope scan.
[Gross Path] Sagittal surfaces of the bisected surgical specimen.
[Gross Path] Sagittal surface of the proximal tibia, magnified.
[X-Ray Path] Lateral radiograph of a coronal slab of the dissected specimen.
[Macro] Macrosection of the coronal slab of the tibial specimen.
[Macro] Macrosection of the coronal slab of the tibial specimen, magnified.