Giant cell tumor of proximal femur managed by extended curettage with fibular strut allograft using long intramedullary interlocking nail: A case report and literature review

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RATIONALE: We first report a unique case of proximal femoral Giant cell tumor of bone, a subtrochanteric lesion associated with femoral neck and intertrochanteric involvement. We chose a completely new surgical approach to treat the primary tumor and preserve the hip joint. No cases of this type have ever been reported. PATIENT CONCERNS: The patient, a 26-year-old man, came to our hospital for treatment of right hip pain more than 4 months ago, had no family history of similar diseases. DIAGNOSES: Based on the imaging results and pathology, a diagnosis of Giant cell tumor of bone was confirmed. INTERVENTIONS: Based on the imaging grade and patients' wishes, the tumor managed by extended curettage and reconstructed with a fibular strut allograft and long intramedullary interlocking nail was used for prophylactic fixation of fractures. The patient did not undergo disuzumab. OUTCOMES: After 40 months of follow-up, although the bone defect finally reached bone healing, the hip function was good, and the tumor did not recur, there were signs of internal fixation loosening at 12 months of the surgery. LESSONS: For young patients with imaging grade <3 who need limb salvage, fibular strut allograft and intramedullary nail-fixation are also an alternative treatment option for hip reconstruction after tumor surgery when the lesion involves the entire proximal femur.

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