In the surgical management of giant cell tumor of bone (GCT), the preferred treatment for a Campanacci Grade III lesion with pathological fracture is:

• A Intralesional curettage alone without adjuvants
• B Intralesional curettage with adjuvant (phenol/liquid nitrogen/argon beam) and bone cement/graft reconstruction
• C Radiation therapy as definitive treatment
• D En bloc resection with endoprosthetic reconstruction ✓

Explanation

Campanacci Grade III GCT involves extension beyond cortex with soft tissue mass. When complicated by pathological fracture (articular collapse) or extensive soft tissue involvement, en bloc resection with endoprosthetic replacement is preferred because intralesional curettage carries an unacceptably high recurrence rate and structural reconstruction would be impossible. For Grade I/II lesions, intralesional curettage with adjuvants (phenol, H2O2, liquid nitrogen, argon beam coagulation) and bone cement/graft is the standard. Radiation is avoided in benign GCT due to risk of post-irradiation sarcomatous transformation.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.