Sandwich technique using neoadjuvant Zolendronate for a Giant cell tumor of distal tibia in a 14 years old girl: A case report

Abstract

Background: Giant Cell Tumor (GCT) of the distal tibia of immature skeleton is a very uncommon occurrence, with very few reports available in literature depicting its course, treatment or complications in immature skeleton. Neoadjuvant Zolendronate holds good promise in the treatment of GCT, decreasing the tumor size and increasing peripheral mineralization, which helps in definitive surgery. Sandwich technique is a novel method of treatment of GCT utilized for subchondral GCTs in distal femur, but there is no report regarding its use for distal tibia. Case report: We present a case of 14 years old adolescent girl who complained of pain, swelling and difficulty in weight bearing of right ankle since 4 months. Diagnosis confirmed it to be GCT of distal tibia. The child was treated with neoadjuvant Zolendronate and Sandwich technique of treatment for the GCT which showed excellent result with no recurrence at a follow-up of 2 years. Conclusion: GCT of distal tibia in immature skeleton although very rare, but can be a possibility. It can be effectively treated using neoadjuvant Zolendronate and Sandwich technique with very favorable clinical and oncological result.

Keywords

• Giant cell tumor distal tibia
• Giant cell tumor immature skeleton
• Pediatric giant cell tumor
• Sandwich technique