En bloc giant cell tumor resection following direct hemiarthroplasty shoulder reconstruction–functional outcome: A case report

INTRODUCTION: Giant cell tumor is a type of benign tumor which has the characteristic of rapidly growing and a chance to metastasis. It is however locally aggressive and would typically affect young patients. They commonly present with pain and associated with pathological fracture. PRESENTATION OF CASE: This is an uncommon case of 29 years old male with pathological fracture and giant cell tumor in proximal humerus. A plain radiograph revealed pathological fracture in head of humerus and histopathology examination was consistent with giant cell tumor. The patient had surgical option with en bloc giant cell tumor resection following hemiarthroplasty with cementless endoprosthetic implant for humerus, which aimed to provide a single step surgery without any interval debulking surgery. The patient had achieved bony union between 6 weeks after the surgery and recurrence was not found by the time of the last follow-up. DISCUSSION: Based on Campanacci’s classification the tumor is divided into 3 stages. The management of giant cell tumors continues to be one of the most challenging areas in orthopedic oncology. Surgery is the first line option; however, it is depending on the tumor staging and can vary from intralesional curettage to total resection of the tumor. Since the local behavior of giant cell tumors has a high risk of local recurrence, en bloc resection and reconstruction were chosen for these Grade III lesions. CONCLUSION: The aim of this procedure is to preserve the shoulder joint shown satisfaction in a clinical, radiological, functional and esthetic result.