A 35-year-old presents with a locally aggressive lytic tumor of the distal radius, extending to the subchondral bone but confined within the cortex with no soft tissue extension. Giant cell tumor (GCT) of bone is suspected. The Campanacci grade that guides the choice between intralesional curettage and resection is:
- A Grade I — conservative intralesional curettage with bone graft
- B Grade II — intralesional curettage with adjuvants (phenol, H2O2, cryotherapy) and cementation
- C Grade II lesions of the distal radius should always be treated with wide resection ✓
- D Grade III — wide resection, as soft tissue extension occurs
Explanation
GCT grading: Campanacci I (well-defined margins, thick cortex), II (no cortical breach, defined but thinned cortex), III (cortical breach, soft tissue extension). For most Grade I–II GCTs at expendable sites (fibula head, distal radius), wide en bloc resection provides lower recurrence rates than intralesional treatment. The distal radius is a unique exception — even Grade II GCTs are treated with wide resection (distal ulnar or fibular head autograft reconstruction) because intralesional treatment at this site has high recurrence rates (25–35%). Grade III lesions universally require wide resection.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
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Written and medically reviewed by the StethoPrep medical team.