A 35-year-old presents with a giant cell tumour (GCT) of the distal radius, Campanacci Grade III (extensive cortical expansion and soft-tissue breach). The most appropriate surgical treatment is:
- A Intralesional curettage with phenol and cement alone
- B Radiation therapy as GCT is radiosensitive
- C Embolisation followed by curettage
- D Wide resection of the distal radius with fibular autograft or osteoarticular allograft reconstruction ✓
Explanation
GCT Campanacci Grade III (soft-tissue extension, cortical disruption) at the distal radius requires wide resection because local recurrence after curettage alone exceeds 25–40% for this grade. Wide en-bloc resection with reconstruction (fibular head autograft for distal radius, preserving the DRUJ of the fibula; or osteoarticular allograft) is the standard for Grade III distal radius GCT. Radiation is reserved for surgically inaccessible GCT (sacrum, spine) and carries a small risk of sarcomatous transformation. Denosumab (anti-RANKL) is a useful neoadjuvant to reduce tumour volume before resection.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.