Although giant cell tumor (GCT) of bone is generally considered a benign but locally aggressive tumor, a small proportion of patients develop pulmonary metastases. Identifying those at greatest risk remains essential for optimizing surveillance and treatment strategies.
In our retrospective study of 466 patients with primary GCT of bone, pulmonary metastases occurred in only 3.2% of cases. Importantly, every patient who developed lung metastases had experienced local recurrence of the primary tumor.
Two findings stood out:
🔹 Recurrent disease was the strongest predictor of pulmonary metastasis, with nearly 10% of recurrent cases developing lung lesions, while no de novo cases metastasized.
🔹 Patients who had undergone previous curettage demonstrated a significantly higher risk of pulmonary metastasis than those treated with primary resection.
Despite the occurrence of lung metastases, the overall prognosis was encouraging. Most patients achieved long-term disease control, and disease-specific mortality remained low during follow-up.
These findings reinforce the importance of preventing local recurrence, carefully selecting the initial surgical strategy, and maintaining vigilant chest surveillance in patients with recurrent GCT. Early recognition of pulmonary metastases allows timely intervention and contributes to favorable oncological outcomes.
Walid Atef Ebeid , Ismail Tawfeek Badr , Mohamed Kamal Mesregah , Bahaa Zakarya Hasan
📖 Reference
Ebeid WA, Badr IT, Mesregah MK, Hasan BZ. Risk factors and oncological outcomes of pulmonary metastasis in patients with giant cell tumor of bone. Journal of Clinical Orthopaedics and Trauma. 2021;20:101499.
Article links
https://pubmed.ncbi.nlm.nih.gov/34290960/
https://www.journal-cot.com/article/S0976-5662(21)00383-0/abstract