Giant Cell Tumor of the Distal Phalanx of the Great Toe: Case Report.

INTRODUCTION: Giant cell tumor (GCT) of bone is a benign but locally aggressive neoplasm that most commonly involves the epiphyseal-metaphyseal regions of long bones. Involvement of the foot is rare, and occurrence in the distal phalanx of the great toe is exceptionally uncommon. GCTs arising in small bones are known to exhibit more aggressive behavior and higher recurrence rates than those in long bones, posing challenges for management.

CASE REPORT: We report the case of a young adult presenting with progressive pain and swelling of the great toe. Radiographs and magnetic resonance imaging demonstrated an expansile osteolytic lesion of the distal phalanx with cortical destruction and soft-tissue extension. Histopathological examination following open biopsy confirmed the diagnosis of GCT of bone. The patient received three doses of denosumab, followed by surgical resection of the distal phalanx with the intent of limb preservation. The post-operative course was uneventful. At the 1-year follow-up, the patient remains symptom-free, with no evidence of recurrence.

CONCLUSION: GCT of the distal phalanx of the great toe is a rare entity with aggressive local behavior. Early diagnosis, histopathological confirmation, and appropriate surgical planning are essential for achieving local control. Limb-preserving strategies can be considered in selected cases, but vigilant follow-up is mandatory due to the high risk of recurrence.