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.