A Rare Location for a Common Bone Tumor, Meta-Diaphyseal Giant Cell Tumor of Bone in an Adult Patient
A 46 years old otherwise healthy female patient was referred to our clinic because of a bone lesion in her left femur. She noticed deep aching pain in her left thigh two months earlier. She denied any history of trauma or any febrile episode during that period. The patient was seen by different physicians and finally an orthopedic surgeon did order a plain X-ray that showed a destructive bone lesion in her left distal femur with a permeative pattern (). Computed tomography (CT) scanning () and magnetic resonance imaging (MRI) () showed that the lesion was located in meta-diaphysial area and it had eroded the anterior bone cortex of left femur, but there was no soft tissue extension by the lesion.\nAll laboratory data including CBC, blood calcium, Phosphorus and Alkaline-Phosphatse level was within normal limits. Serum parathyroid assay reported to be within normal range. All other staging studies including chest and abdomen CT scan and whole body bone scanning was negative for any other abnormal lesion. Because of her age and the pattern of the lesion, she underwent an open incisional bone biopsy. The result was compatible with primary giant cell tumor of bone ().\nSubsequently she underwent curettage and internal fixation with a side plate augmented with bone cement. She did recover uneventfully and so far with a follow-up of 24 months she is doing good and there is no local recurrence for the lesion detected.