Giant cell tumor of bone is a locally aggressive, usually benign bone neoplasm that occurs most commonly in the distal femur and proximal tibia in young adults. The diagnosis is usually not difficult; typical radiographic features include an eccentric radiolucent lesion with a narrow zone of transition and a nonsclerotic margin with a juxta-articular location. Considerable progress has been made in the understanding of the behavior of this neoplasm. Whereas surgical margins are important for local tumor control, wide margins achieved with a surgical resection are not necessary for most patients. Thorough curettage and the use of polymethylmethacrylate as a filling material have reduced the rates of local recurrence from 50 to 60% to less than 15%. The benefit of other physical adjuvants such as phenol and liquid nitrogen in achieving local control is controversial. Pulmonary metastases of benign giant cell tumors of bone occur in approximately 2% to 3% of patients. Continued surveillance of these patients with plain radiographs after treatment is necessary for early detection of local recurrence and pulmonary metastases.
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