Giant Cell Tumor of Bone and Soft Tissue

What are giant cell tumors?

Giant cell tumors (GCT) are benign (noncancerous) tumors. They usually form near a joint in the long bones of the arms and legs. These tumors can be aggressive and grow very fast. They develop when many benign cells group together to form a large mass.

There are 2 types of giant cell tumors: giant cell tumors of the bone and giant cell tumors of the tendon sheath. The tendon sheath is the membrane that surrounds a tendon. Giant cell tumors of the tendon sheath are rare in children.

Even though these tumors are benign, they often need to be treated with surgery. Sometimes these tumors spread to other parts of the body and become cancerous. This is rare.

Giant cell tumors of the bone and soft tissue are rare in children and teens. They occur most often in young adults, ages 20–40. Scientists do not know why most GCTs occur.

Symptoms of giant cell tumors

The most common symptoms of giant cell tumors of the bone include:

• Joint pain and swelling
• Trouble moving the joint
• A lump at the tumor site
• A broken bone

Giant cell tumors of the tendon sheath often do not cause pain at first. As the tumor grows, symptoms may include:

• A lump at the tumor site
• Swelling and pain

Risk factors of giant cell tumors

The specific risk factors for giant cell tumors are not known.

Diagnosis of giant cell tumors

Doctors use several procedures and tests to diagnose giant cell tumors. These include:

• A health history, physical exam, and blood tests to learn about symptoms, general health, past illnesses, and risk factors
• Imaging tests such as:
  • An x-ray to check for bone cancer
    
  • A CT scan to see if the giant cell tumor has spread to other parts of the body 
  • An MRI scan to evaluate the tumor and help plan for surgery
  • A biopsy of the mass to check for cancer
  • A bone scan to look inside the bone

Types of giant cell tumors

There are 2 types of giant cell tumors: giant cell tumors of the bone and giant cell tumors of the tendon sheath. The tendon sheath is the membrane that surrounds a tendon.

GCTs develop when cells form a large mass. These tumors usually appear in young adults when bones have stopped growing.

Giant cell tumors of the bone are rare. 

Giant cell tumors of the tendon sheath are somewhat common in adults. 

Treatment of giant cell tumors

Surgery

The treatment for giant cell tumors usually starts with surgery. Surgeons remove as much of the tumor as possible. This may include removing some of the bone. Bone reconstruction is done if needed.

In some cases, the patient may require amputation to completely remove the tumor.

After surgery

Patients may need more treatment and therapy after surgery. This may include:

• Radiation: Sometimes a tumor cannot be removed completely. Radiation therapy may be used to shrink and destroy the remaining tumor
• Chemotherapy: Chemotherapy may be used if the tumor cannot be removed completely.
• Medication: Patients may be given a monthly medicine that decreases bone breakdown.
• Physical therapy: Physical therapists help patients regain strength, balance, flexibility, and mobility.

Giant cell tumors can return. If they do, they usually return or in the same location. Some patients need more than 1 surgery or type of treatment to remove the tumor.

Prognosis for giant cell tumors

Prognosis depends on several factors:

• If the tumor has spread to other parts of the body
• If surgery completely removes the tumor
• If the tumor returns

With proper treatment, many patients with giant cell tumors are cured of their disease.

Talk to your care team about problems to expect and ways to manage them. Palliative care can help you manage symptoms, promote quality of life, and make informed decisions.

Support for patients with giant cell tumors

Your child may need follow-up care for a long time after treatment ends. This care includes screening to see if the tumors return.

All survivors should have regular checkups and screenings by a primary health care provider. Your child is encouraged to be physically active, eat healthy, and get enough sleep. These lifestyle habits promote general health. They also help prevent diseases.

Survivors of bone cancer tend to be less active. Regular exercise is important to maintain health, fitness, and physical function.

Your child’s care team should give you a survivorship care plan after treatment ends. This report will include needed screening tests and tips for a healthful lifestyle.

Questions to ask your care team

• What are our treatment options for giant cell tumors?
• What are the possible side effects of treatment?
• What can be done to manage side effects?
• Will my child need to be in the hospital for treatment?
• Where is treatment available? Is it close to home or will we have to travel?
• Will my child have physical limitations after treatment?