The interdisciplinary approach of an aggressive giant cell tumor of bone complicated with a fracture of the distal femur

Vol. 57 No. 2 Suppl., 2016
This supplement was not sponsored by Outside Organizations.

ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Iulian Daniel Vilcioiu, Dragos-George Zamfirescu, Ioan Cristescu, Andrei Ursache, Serban-Arghir Popescu, Cosmin Antoniu Creanga, Ioan Lascar

Giant cell tumor of bone (GCTB) represents one of the commonest bone tumors encountered by an orthopedic surgeon. The giant-cell tumor is generally classified as benign but the fast growing rhythm and the aggressive soft-tissue invasion may in some cases demonstrate a malign potential of the tumor. We present the case of an aggressive giant cell tumor in a young patient that was first diagnosed in our emergency department with a fracture of the distal femur after a low energy trauma. With further examinations, we discovered that the tumor was invading the both femoral condyles and was vascularized by three major arterial pedicles. The onset of his problems was the femoral fracture and the changes on the major vessels, muscles and nerves. After an interdisciplinary approach of the patient and a meticulous preoperative planning, we decided to make an extensive total resection of the tumor followed by a complex reconstruction surgery for the bone. A very stable fixation of a vascularized graft allowed the bone to heal even if the surrounded soft-tissue was almost completely invaded by the tumor and removed during the excision. The follow-up of this case demonstrated that using an interdisciplinary approach of the patient with the Plastic Surgery team, we manage to remove the tumor within oncological limits and achieved bone healing with good stability of the distal femur.

Corresponding author: Dragos-George Zamfirescu, MD, PhD; e-mail: dragoszamfirescu@gmail.com

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ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Oana Cella Andrei, Ruxandra Margarit, Livia-Alice Tanasescu, Luminita Daguci, Constantin Daguci

Extremely old, complete edentulous patients are very difficult to treat both because of their anatomical and psychological condition. Treatment challenges are increasing when this situation is associated with low socio-economic status, poor general health and unrealistic expectations. This article presents a prosthetic rehabilitation of a very old patient, presenting a serious bone atrophy associated with a maxillary flabby ridge, whose dentures accelerated the bone resorption because of their poor fitting, lack of retention and wrong occlusal contacts. Despite his old age and scarce social life, restoring esthetics in the trial phase had a major psychological impact for the patient, making him more optimistic about the result and helping him to accept and functionally integrate the new complete dentures.

Corresponding author: Livia-Alice Tanasescu, Assistant, MD, PhD; e-mail: tanasescualice@gmail.com

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