Revolutionizing Limb Preservation: A Case Report on Recurrent Fungating Giant Cell Tumor with Encased Radial Artery in the Distal Radius

肢体保留的革命性突破:一例桡骨远端包裹桡动脉的复发性蕈状巨细胞瘤病例报告

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Abstract

INTRODUCTION: Giant cell tumor (GCT) of the bone, although benign, poses significant challenges due to its locally aggressive nature and high recurrence rates post-surgical intervention. Among skeletal GCTs, those affecting the distal radius present unique difficulties, especially when fungating masses encase vital structures such as blood vessels. CASE REPORT: We present a case of a 28-year-old male with a recurring GCT of the distal radius, where limb-preserving surgery was successfully performed despite encasement of the radial artery. Surgical excision followed by wrist arthrodesis utilizing ulnar centralization resulted in satisfactory outcomes, emphasizing the importance of tailored surgical approaches for optimal functional preservation. Despite encountering local recurrence, subsequent excision and reconstruction utilizing vacuum-assisted closure and skin grafting achieved successful limb salvage with no evidence of further recurrence at the 18-month follow-up. CONCLUSION: This case study contributes valuable insights into rare limb salvage techniques applicable to challenging GCT presentations, advocating for personalized treatment strategies to mitigate recurrence risk and preserve patient quality of life.

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