[Giant cell tumor of bone. An analysis of 69 cases]. / Der Riesenzell-Tumor des Knochens. Eine Analyse von 69 Fällen.

1. The tumor stage of the giant cell tumor is an indicator for the prognosis and the need for adjuvant therapy. 2. Intralesional excisions without an adjuvant result in high rates of recurrence. 3. Polymethyl methyl acrylate (PMMA) largely prevents recurrences, provides stability and makes early functional treatment possible. 4. Broad excisions should only be performed in bone which is dispensable. 5. Recurrences frequently manifest themselves by pain. They can be removed intralesionally, as in primary therapy.

Musculoskeletal neoplasms: static and dynamic Gd-DTPA--enhanced MR imaging.

Static and dynamic magnetic resonance imaging studies were performed in 69 patients with bone and soft-tissue tumors. T1-weighted spin-echo (SE) imaging after intravenous administration of gadolinium diethylenetriaminepentaacetic acid (DTPA) improved the differentiation of necrotic from viable areas; the contrast-to-noise ratio (C/N) between tumor and muscle was an average of 44% lower compared with that in T2-weighted SE imaging. The C/N between tumor and bone marrow or fatty tissue was 43% and 37% lower, respectively, compared with that in nonenhanced T1-weighted SE imaging. Dynamic changes of signal intensity (SI) after Gd-DTPA enhancement were assessed with fast low-angle shot imaging. Of malignant tumors, 84.1% exhibited slopes higher than 30% per minute; 72% of benign tumors showed slopes lower than 30% per minute. The dynamic technique enabled assessment of the malignant potential of a tumor with some overlap (accuracy, 79.7%). Necrotic areas and peritumorous edema showed significantly lower and more gradual increases in SI than adjacent neoplastic tissue.

[Giant cell tumor of bone]. / Der Riesenzelltumor des Knochens.

This retrospective study analyses 67 patients with 69 giant cell tumors of bone staged according to the Surgical Staging System of benign and malignant lesions of Enneking (1980, 1986). A significant correlation between Stage 2 and Stage 3 benign lesions in respect to local recurrence as well as between the therapeutic procedures and recurrence was found. Intralesional excision with temporary acrylic cement implantation showed to be the preferable initial treatment of these tumors. Special attention to surgical staging, surgical techniques and a supervised rehabilitation program minimize the incidence of recurrence and at the same time giving am maximum of joint function.