Giant cell tumour of bone (GCTB) is a usually benign but locally aggressive lesion that typically affects the methaepiphysis of long bones. Incidence peaks around 30-40 years, and the tumour is slightly more common in women than in men. Treatment is usually surgical; a combination of intralesional curettage, high speed burring of the cavity (to achieve an extra millimetre of resection of the tumour margins), and filling of the defect with bone cement cures patients in as much as 90% of cases. Although rare, complicated GCTB can occur, in which patients develop pulmonary metastases, the disease is multicentric, or tumours arise in locations where surgical removal is very difficult-eg, axial skeleton. In these cases, surgery alone does not lead to satisfactory results and adjuvant medical treatment is needed. Histologically, GCTB consists of multiple multinucleated giant cells with strong phenotypic similarities to osteoclasts, mononucleated histiocytes (which are thought to be secondarily recruited), and spindle-shaped proliferative stromal cells (which are thought to be the neoplastic cell component).
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