Giant cell tumor


Distribution of giant-cell tumors of bone
  • Benign tumor that is locally aggressive causing osteolytic destruction
  • Although classified as benign lesions, metastasis does occur in a small percentage of patients, typically to lungs
    • These are known as benign pulmonary implants as they do not carry the same poor prognostic implication as lung metastasis from other malignancies
  • 3% to 5% of all primary bone tumors
    • Around 20% in the Chinese population
  • Increased incidence in patients who have been diagnosed with Paget disease of the bone

Clinical Features

  • Pain and edema over a joint near a long bone (usually around the knee)
    • Classically in a young female adult
  • Can present as a pathological fracture
  • Nearly all present with just a single tumor site

Differential Diagnosis

Bone tumors and their mimics





X-ray of a giant-cell bone tumor in the head of the fourth metacarpal of the left hand
  • Plain radiograph showing a large lytic mass with soap bubble appearance
  • Obtain chest plain film to look for pulmonary metastasis
  • CT and MRI for more accurate assessment of tumor
    • Possibly can be done as outpatient
  • Biopsy for definitive diagnosis


  • Surgery is the treatment of choice
  • RANKL inhibitors (Denosumab) for unresectable metastatic disease
  • Can recur locally after curettage


  • Home with outpatient follow up
  • Admission if necessary for pain control or significant disease burden


  1. Czerniak, Bogdan. “Benign Osteoblastic Tumors.” Dorfman and Czerniak's bone tumors. Elsevier Health Sciences, 2015, pp. 144 – 199.