Giant cell tumor of the bone (GCTB) is a locally aggressive benign neoplasm with a significant propensity for local recurrence following intralesional surgery. Isolated involvement of the lateral condyle of the distal femur is uncommon. Extended intralesional curettage with chemical adjuvants and polymethylmethacrylate bone cementing is the accepted limb-salvage treatment. Management of recurrent disease, particularly with repeat joint-preserving surgery, and long-term outcomes beyond 10 years following revision procedures remain underreported in the literature. A 40-year-old male presented with a six-month history of right knee pain and difficulty walking. Radiography demonstrated a well-defined eccentric expansile lytic lesion with a soap-bubble appearance involving the lateral condyle of the right distal femur. Computed tomography confirmed cortical erosion and soft-tissue involvement. Fine-needle aspiration cytology yielded hemorrhagic fluid. Histopathology confirmed giant cell tumor. The patient underwent extended curettage, phenolization, and gentamicin-infused cementing in August 2012. Two years later, local recurrence was detected radiologically; repeat extended curettage and re-cementing were performed in September 2014. The patient remained disease-free at a 13-year follow-up (February 2026) with full knee range of motion, bilateral weight-bearing ambulation, and a structurally intact cement mantle on serial radiographic surveillance. This case proves that repeated curettage with phenolization and cementation is a viable option for limb salvage in cases of recurrent GCTB involving the distal femoral lateral condyle without radiographic spread. Thirteen years of tumor-free survival, functional integrity, and persistence of cement mantle after repeated procedures indicate the efficacy of the procedure, making it a preferable option to wide excision.
Mankar et al. (Wed,) studied this question.