Recurrent Giant Cell Tumor of the Carpal Bones in an Adult Male Managed by En-bloc Excision, Extended Curettage, Bone Grafting, and all-Kirschner Wire Fixation: A Rare Case Report and Literature Review.

INTRODUCTION: Giant cell tumor of bone (GCTB) is a benign but locally aggressive lesion, rarely affecting the carpus (<2% of hand GCTs), and is associated with recurrence rates up to 87%. Management of carpal GCT is challenging due to the limited bone volume, risk of damage to articular cartilage, and the need to preserve wrist function.

CASE REPORT: A 38-year-old male presented with recurrent GCT of his left wrist 1 year after curettage and bone grafting. He had painful swelling, restricted motion, and an expansile lesion involving the distal carpal row and bases of the 2nd-4th metacarpals. He underwent en bloc excision with extended curettage and reconstruction using iliac crest autograft stabilized by Kirschner wires. Post-operatively, he had good pain relief and maintained good wrist motion. At 12 months, positron emission tomography - computed tomography showed no recurrence or metastasis; Mayo Wrist Score was 85 (Good) and the disabilities of the arm, shoulder and hand score was 8.3.

CONCLUSION: Recurrent carpal GCTB can be managed with en bloc excision, extended curettage, autografting, and temporary fixation, achieving adequate disease control and preservation of wrist motion. Long-term surveillance remains essential as recurrence is high in lesions of the carpal bones.