Under a Giant cell tumor a tumor on the bone is understood. The giant cell tumor is also synonymous with the medical term Osteoclastoma designated. The dignity of the tumor is not clear in the majority of cases. The name of the giant cell tumor is derived from its typical appearance that is visible under the microscope. This shows large cells with several nuclei, which are called giant cells.
What is a giant cell tumor?
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The origin of the Giant cell tumor lies in those cells that are between the giant cells. These cells are similar to fibroblasts. In some cases, the giant cell tumor on the bone is mistaken for a tumor on the tendon sheath, which is also characterized by giant cells.
In fact, there are two completely different diseases. The degree of malignancy of the tumor can be determined on the basis of the mitoses and cells with pathological properties. A giant cell tumor often occurs in the so-called epiphyses, which are located inside the long tubular bones.
The tumor is characterized by an aggressive growth behavior, which is why it is also considered a semi-malignant disease. The giant cell tumor often occurs near the knee joint, the proximal humerus, or the distal radius. About every 7th tumor on the bones that is benign in character is a giant cell tumor.
causes
The causes that lead to the formation of giant cell tumors have not yet been fully clarified according to the current state of medical science. Although there are various theories about potential reasons for the development of the tumor, no reliable statements have been made so far. However, several studies and research projects are working to elucidate the causes of giant cell tumors.
Symptoms, ailments & signs
A giant cell tumor is associated with various symptoms and complaints, which differ depending on the individual case. For example, the disease causes pain and swelling in the affected area. Pathological fractures, which are favored by the giant cell tumor, are also possible.
In the majority of cases, giant cell tumors develop in the limb area. Only in 25 percent of cases do the tumors appear on the trunk. If giant cell tumors occur on the extremities, they are usually limited to the epiphysis on the large tubular bones. They represent one of the most common non-malignant types of tumors on bones.
Due to their localization in the epiphysis, they are very often found near the joints, for example on the knee joint. In the vast majority of cases, adolescent patients or young adults develop this special type of bone tumor. It often takes a long time before the giant cell tumor is discovered.
Because giant cell tumors generally grow very slowly, even if they are aggressive forms. They also do not cause pain in many people. In addition, giant cell tumors only rarely lead to the formation of daughter tumors in other areas of the body. However, giant cell tumors often grow into the surrounding tissue.
It is also typical that giant cell tumors tend to recur after surgical removal. Basically, the individual symptoms are strongly dependent on the respective location of the giant cell tumor. Pain in the joints is possible, and mobility is also impaired in some cases. In addition, in some cases, effusions occur in nearby joints.
Diagnosis & course of disease
Various examination technology options are available for diagnosing giant cell tumors. It is at the discretion of the attending physician to decide on their use. Before performing any clinical examinations, the doctor will analyze the patient's medical history.
X-ray examinations, magnetic resonance imaging and a biopsy are then possible. As a rule, imaging procedures are always used. The X-ray examination reveals so-called osteolytic areas that indicate the giant cell tumor. The tumor causes the affected bone to expand, and soft tissue infiltration may also occur.
Complications
The giant cell tumor is usually benign. Serious malignant courses leading to death very rarely occur. However, the tumor can grow aggressively locally and affect the affected bone tissue. This causes the bones to widen, which can often lead to joint pain with limited mobility, swelling, bone fractures and effusions in adjacent joints.
Since the giant cell tumor is usually benign, but can cause local destruction of the bone structure, it is sometimes referred to as a semi-malignant tumor. The local destruction of the bones can cause severe restrictions on movement, which can sometimes only be treated with the use of artificial joints.
Treatment should be given early to prevent these long-term effects. As part of the therapy, the tumor is removed by curettage (scraping) of the bones. However, a relapse can occur in around 25 percent of cases. The giant cell tumor may also form metastases in the lungs. In contrast to most other cancers, even the metastases here are benign.
The development of lung metastases is very rare. Metastases in other organs are even less common. As already mentioned, the tumor usually only develops its destructive power locally. Nevertheless, in individual cases the tumor can degenerate and turn into a malignant sarcoma. In these few cases, the prognosis is very poor.
When should you go to the doctor?
If there is swelling, reduced mobility, and repeated fractures, a giant cell tumor may be the cause. Medical help is needed if the symptoms do not subside or even get worse. If severe pain or a bone fracture occurs, the doctor should be contacted immediately.
People who have typical risk factors such as an unhealthy diet, the consumption of nicotine or a weakened immune system must take regular preventive medical checkups. If the symptoms mentioned occur in connection with a predisposition, a quick visit to the doctor is recommended.
The giant cell tumor is clarified by your family doctor or an orthopedic surgeon. Depending on the symptoms, dermatologists, internists and oncologists can also be consulted. The treatment is inpatient in a hospital. The doctor will then call in various physiotherapists and, if necessary, alternative doctors who will support the patient in the follow-up care. If similar symptoms reappear after recovery, the doctor must be informed in order to clarify complications such as a relapse or permanent bone damage.
Treatment & Therapy
A giant cell tumor can be treated with various measures. Basically, the treatment depends on the patient's age and medical history. Often either a resection or a curettage is performed, in which the affected area is filled with bone cement.
In some cases it is necessary to replace or reconstruct the diseased joint. In principle, physiotherapy sessions are prescribed following surgical interventions in order to regain mobility and muscle strength. As a rule, several years of follow-up are required in order to quickly identify possible recurrences.
In some cases, chemical agents such as phenol are also used to eliminate all tumor cells. Very rarely, in less than five percent of all affected people, metastasize in connection with the giant cell tumor. In the majority of cases, this affects the lungs.
prevention
With regard to effective measures and methods for the prevention of giant cell tumors, no reliable statements can be made according to the current state of medical and pharmaceutical science. This is primarily due to the fact that so far too little is known about the causes of giant cell tumors.
In numerous cases, giant cell tumors also show no or only weak symptoms for a long time and are therefore often only recognized late. It is therefore important to clarify complaints quickly.
Aftercare
The location of the giant cell tumor influences the necessary follow-up care. Giant cell tumors mainly occur in epiphyseal regions. This means that they are close to the joint or penetrate into the joint. In 50 percent of the diseases, the tumor occurs in the knee region. The surgical removal of the diseased bone and joint substance therefore usually results in a restriction of mobility.
Physiotherapy is usually prescribed to increase mobility after the operation and to strengthen the muscles. Giant cell tumors have a recurrence rate of 25 percent. A careful and regular follow-up by a doctor over several years is therefore indicated. If the removed bone substance has been filled with bone cement, it can be replaced during the follow-up.
This is possible if the course has been monitored over several years and the risk of a relapse is assessed as low. The sick person can also take measures that have a positive influence on the course of the disease. This includes careful introspection. If symptoms similar to those of the first illness occur again, he should see a doctor. A healthy lifestyle is advisable to reduce the likelihood of recurrence. The sick person should eat a balanced diet, exercise regularly and sufficiently and avoid emotional stress.
You can do that yourself
A giant cell tumor can often be surgically removed. The patient must first and foremost take into account the medical guidelines regarding diet, rest and medication. In addition, it is important not to lift heavy loads in the days after an operation. If the operation is successful, recovery is likely to be rapid, provided the tumor has not yet spread.
To ensure this, medical follow-up checks must be used and physical warning signals clarified. An active lifestyle with sufficient exercise and a balanced diet lowers the risk of developing illness. Corresponding changes also improve the quality of life and thus the mental health, which is usually ailing after a tumor disease.
Counseling sessions and participation in a self-help group also help. Giant cell tumors promise a good prognosis if they are detected in good time. Therefore, the focus of treatment is on regular preventive examinations.
Patients who experience bleeding or pain as a result of an operation should consult their doctor and inform them of the symptoms and symptoms. The same applies to unusual pain in other areas of the body. If there is any suspicion that a relapse has occurred, medical advice is also required.
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