Clinical case: Giant cell tumor of the distal third of the radius. Diagnosis, surgical treatment

Caso clínico: Tumor de células gigantes de tercio distal de radio. Diagnóstico, tratamiento quirúrgico

The distal third of the radius is the most common location for giant cell tumors (GCTs) in the upper extremity. This case presents an unusual clinical course, characterized by aggres- sive progression and atypical patterns of recurrence. The complexity of the case highlights the biological variability of GCTs and underscores the need for conservative, innovative therapies that prioritize limb preservation and extended follow-up beyond standard pro- tocols. Treatment must balance the goals of functional preservation with the prevention of recurrence and complications. Given the lack of clear standards for surgical treatment, multiple techniques have been described. This study provides an overview of the eva- luation of GCTs in the distal radius, analyzes therapeutic options, and offers an updated summary of outcomes. Surgical management should consider tumor grade, joint involve- ment, and individual patient factors. Options include intralesional curettage or en bloc resection with reconstruction. Regarding reconstruction, joint-preserving procedures for the radiocarpal articulation are preferred. Grade 1 tumors (according to the Campanacci classification) can be successfully treated with joint-preserving techniques, whereas for grade 3 tumors, joint resection is recommended to prevent recurrence. The management of grade 2 tumors remains controversial. When articular surface preservation is feasible, intralesional curettage with adjuvants has shown good outcomes, while en bloc resection is reserved for cases where aggressive curettage is not possible.