Giant cell tumor of distal ulna treated using en-bloc resection combined with extensor carpi ulnaris and flexor carpi ulnaris tendon stabilization: A case report

INTRODUCTIONGiant Cell Tumor (GCT) is a form of bone tumor which is rare, benign, and locally invasive. To date, there have not been many case reports regarding cases of GCTs on the distal ulna which made the optimum strategy in management remain controversial. In some reported cases, the patient wa...

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Veröffentlicht in:International journal of surgery case reports 2021, Vol.79, p.362-367
Hauptverfasser: Solichin, Iman, Martika, Windi, Wikanjaya, Rio
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container_title International journal of surgery case reports
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Martika, Windi
Wikanjaya, Rio
description INTRODUCTIONGiant Cell Tumor (GCT) is a form of bone tumor which is rare, benign, and locally invasive. To date, there have not been many case reports regarding cases of GCTs on the distal ulna which made the optimum strategy in management remain controversial. In some reported cases, the patient was treated with wide excision followed by reconstructive procedure resulting in ulnar translation of the carpal bones and dynamic convergence of the ulna towards the radius. PRESENTATION OF CASEWe documented a case of 29-year-old male with distal ulna GCT, treated with en-bloc resection combined with extensor carpi ulnaris and flexor carpi ulnaris tendon stabilization. The key objectives of GCT treatments are to avoid local recurrence with sufficient resection and to maintain the function of the limbs. Specific treatment options have been suggested for en-bloc resection with or without the need for ulnar reconstruction or stabilization, even prothesis. In this case, we excised the distal portion of the ulna with some soft tissue procedure for added stability. CLINICAL DISCUSSIONThree weeks after the surgery, the patient was able to perform wrist flexion and extension, fingers abduction, adduction, and opposition with slight limitation. The DASH and PRWE score had improved gradually within 3 weeks and 6 months after the surgery. CONCLUSIONIn the subsequent evaluation after six months of the surgery, the patient achieved full restoration of forearm function without any limitation.
doi_str_mv 10.1016/j.ijscr.2021.01.065
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To date, there have not been many case reports regarding cases of GCTs on the distal ulna which made the optimum strategy in management remain controversial. In some reported cases, the patient was treated with wide excision followed by reconstructive procedure resulting in ulnar translation of the carpal bones and dynamic convergence of the ulna towards the radius. PRESENTATION OF CASEWe documented a case of 29-year-old male with distal ulna GCT, treated with en-bloc resection combined with extensor carpi ulnaris and flexor carpi ulnaris tendon stabilization. The key objectives of GCT treatments are to avoid local recurrence with sufficient resection and to maintain the function of the limbs. Specific treatment options have been suggested for en-bloc resection with or without the need for ulnar reconstruction or stabilization, even prothesis. In this case, we excised the distal portion of the ulna with some soft tissue procedure for added stability. CLINICAL DISCUSSIONThree weeks after the surgery, the patient was able to perform wrist flexion and extension, fingers abduction, adduction, and opposition with slight limitation. The DASH and PRWE score had improved gradually within 3 weeks and 6 months after the surgery. 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To date, there have not been many case reports regarding cases of GCTs on the distal ulna which made the optimum strategy in management remain controversial. In some reported cases, the patient was treated with wide excision followed by reconstructive procedure resulting in ulnar translation of the carpal bones and dynamic convergence of the ulna towards the radius. PRESENTATION OF CASEWe documented a case of 29-year-old male with distal ulna GCT, treated with en-bloc resection combined with extensor carpi ulnaris and flexor carpi ulnaris tendon stabilization. The key objectives of GCT treatments are to avoid local recurrence with sufficient resection and to maintain the function of the limbs. Specific treatment options have been suggested for en-bloc resection with or without the need for ulnar reconstruction or stabilization, even prothesis. In this case, we excised the distal portion of the ulna with some soft tissue procedure for added stability. CLINICAL DISCUSSIONThree weeks after the surgery, the patient was able to perform wrist flexion and extension, fingers abduction, adduction, and opposition with slight limitation. The DASH and PRWE score had improved gradually within 3 weeks and 6 months after the surgery. 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title Giant cell tumor of distal ulna treated using en-bloc resection combined with extensor carpi ulnaris and flexor carpi ulnaris tendon stabilization: A case report
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