An Unusual and Complicated Course of a Giant Cell Tumor of the Capitate Bone

Abstract EN

A 51-year-old female patient presented with a carpal giant cell tumor (GCT) of the right capitate bone.

The lesion was initially misdiagnosed as having an osteomyelitis.

First, the diagnosis of a benign GCT was confirmed by histological examination.

Second, an intralesional curettage and packing of the cavity with cancellous iliac crest bone grafts combined with a fusion of the third carpometacarpal (CMC III) joint were carried out.

Third, due to a secondary midcarpal osteoarthritis and a secondary scaphoid nonunion, the CMC III joint fusion plate was removed and the midcarpal joint completely excised.

Fourth, in the absence of recurrence of GCT, a four-corner fusion (4CF) with a corticocancellous iliac crest bone graft and complete excision of the scaphoid bone had to be performed.

Fifth, a total wrist arthroplasty (TWA) was performed due to hardware failure of 4CF with migration of a headless compression screw into radiocarpal joint which led to erosion of articular surface of the distal radius.

At the 3-year follow-up that includes a 1-year follow-up after TWA, there was no recurrence of GCT, and the TWA was not failed.

The patient reported that she would have the motion-preserving TWA again.