Giant-cell tumor of bone

Giant-cell tumors are benign but considered "aggressive" because of their capacity to rapidly destroy bone. They are most common in young adults and usually seen around the knee. Simple "curettage" (i.e. only mechanical removal) is associated with frequent tumor recurrence.

For many years, we have treated these tumors with a combination of curettage, cryosurgery (the use of liquid nitrogen to freeze tumor cells) and reconstruction with metal rods, cement and bone graft. Using this protocol, we have achieved a recurrence rate of less than 5% with a low complication rate. Other benign but aggressive bone tumors such as aneurysmal bone cysts and low-grade bone malignancies such as low-grade chondrosarcomas are treated similarly.

Osteoid osteoma

Osteoid osteoma is a small but typically very painful bone tumor found in children and young adults. It is always benign and most common in the lower extremities. Depending on the location, this tumor can be "killed" using a special probe that delivers radio-frequency waves directly onto the bone ("Radiofrequency Ablation"), without surgery.

In other cases, the tumor is localized using a CT scan and surgically removed by using a high-speed drill to carefully burr the bone surface where the tumor is located.

Pigmented Villonodular Synovitis (PVNS)

PVNS is a benign soft-tissue tumor of the joint lining, most common in the knee. It is considered "aggressive" because it has the capacity to slowly destroy the joint. Many patients have had more than one previous unsuccessful surgery before being referred to us. Arthroscopic removal rarely succeeds in completely removing PVNS.

For many years, we have used a protocol of sequential surgical resections in order to completely remove the tumor followed by radiation therapy to kill any remaining tumor cells.

With this regimen, our patients have had almost no recurrences and have maintained excellent function of their joints.

Metastatic Tumors

The large majority of skeletal tumors actually arise from non-skeletal locations; that is, they are "metastatic". The most common origins are breast, lung, thyroid and renal cancers. These metastatic lesions are usually painful and sometimes cause the bone to break ("pathological fracture").

Our familiarity with skeletal reconstruction after large bone resections allows us to achieve reliable results with even large metastatic lesions. In addition, our experience with cryosurgery often offers additional surgical options in removing the tumor.

We also have extensive experience with the use of pre-operative embolization (selective blockage of arteries that feed a tumor) to make surgery safer, or even feasible, in situations where the tumor has an extensive blood supply, such as with metastatic kidney tumors