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Giant Cell Tumor and Aneurysmal Bone Cyst of the Talus: Clinicopathological Review and Two Case Reports

Martin M. Malawer, R M Vance

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Abstract

Two cases of giant cell tumor and aneurysmal bone cyst of the talus were analyzed with a review of eight cases from the literature. This anatomic setting represents a distinct clinical and roentgenographic entity with a less aggressive natural history than the more common sites. All lesions presented a characteristic radiographic involvement of the head and neck of the talus. Eight of ten lesions were treated by curettage, with or without bone grafting, and healed. Two underwent partial en bloc resection. None developed late fracture, recurrence, avascular necrosis, or metastases. We concluded that a giant cell tumor or aneurysmal bone cyst when located in the talus may be difficult to differentiate but tends to exhibit a less aggressive biological behavior and a more favorable prognosis than the more classical proximal lesion. Talectomy is not indicated in the primary treatment. Curettage with or without bone graft has a high success rate. Cryosurgery should be reserved for a recurrent lesion.

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What this paper is about

Two cases of giant cell tumor and aneurysmal bone cyst of the talus were analyzed with a review of eight cases from the literature. This anatomic setting represents a distinct clinical and roentgenographic entity with a less aggressive natural history than the more common sites. All lesions presented a characteristic radiographic involvement of the head and neck of the talus. Eight of ten lesions were treated by curettage, with or without bone grafting, and healed. Two underwent partial en bloc resection. None developed late fracture, recurrence, avascular necrosis, or metastases. We concluded that a giant cell tumor or aneurysmal bone cyst when located in the talus may be difficult to differentiate but tends to exhibit a less aggressive biological behavior and a more favorable prognosis than the more classical proximal lesion. Talectomy is not indicated in the primary treatment. Curettage with or without bone graft has a high success rate. Cryosurgery should be reserved for a recurrent lesion.

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Available abstract

Two cases of giant cell tumor and aneurysmal bone cyst of the talus were analyzed with a review of eight cases from the literature. This anatomic setting represents a distinct clinical and roentgenographic entity with a less aggressive natural history than the more common sites. All lesions presented a characteristic radiographic involvement of the head and neck of the talus. Eight of ten lesions were treated by curettage, with or without bone grafting, and healed. Two underwent partial en bloc resection. None developed late fracture, recurrence, avascular necrosis, or metastases. We concluded that a giant cell tumor or aneurysmal bone cyst when located in the talus may be difficult to differentiate but tends to exhibit a less aggressive biological behavior and a more favorable prognosis than the more classical proximal lesion. Talectomy is not indicated in the primary treatment. Curettage with or without bone graft has a high success rate. Cryosurgery should be reserved for a recurrent lesion.

Key concepts: Aneurysmal bone cyst, Curettage, Medicine, Giant cell, Lesion, Bone grafting, Bone cyst, Giant-cell tumor of bone

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