Giant cell tumors (GCT) of the distal radius are relatively common and typically treated with extended curettage and reconstruction using bone grafts or bone cement to preserve function. In contrast, GCTs of the distal ulna are rare but locally aggressive, often managed with en-bloc resection to reduce recurrence risk while balancing wrist stability and function. Both locations may present with pain, swelling, and risk of pathological fractures due to bone destruction. Long-term monitoring is important to detect recurrence or, rarely, metastasis.
Giant cell tumors (GCTs) of the distal radius and ulna are benign but locally aggressive bone neoplasms that commonly affect young adults. The distal radius is the most frequent site in the upper extremity, often presenting with pain, swelling, and limited wrist motion. These tumors have a high tendency to recur, especially if not completely excised.
In the distal radius, treatment aims to balance tumor control with preservation of wrist function. Options include curettage with adjuvants, wide resection, and reconstructive procedures such as ulnar translocation or wrist arthrodesis. Wide resection reduces recurrence risk but may compromise wrist mobility, while curettage preserves function but carries higher recurrence rates.
GCTs of the distal ulna are rarer but tend to be more aggressive, with a significant risk of local recurrence, particularly in advanced (Campanacci grade III) cases. En bloc resection is often preferred for distal ulna tumors, as it lowers recurrence and can yield good functional outcomes when combined with appropriate soft tissue reconstruction.
Preoperative therapies, including short courses of denosumab, have shown promise in reducing tumor size and facilitating surgery. Radiological imaging plays a crucial role in diagnosis, surgical planning, and follow-up, with MRI and CT scans helping to assess tumor extent and soft tissue involvement.
Overall, management of GCTs in these locations requires a multidisciplinary approach to optimize oncological control while maintaining as much wrist and forearm function as possible. Long-term monitoring is essential due to the risk of recurrence.
Giant cell tumors of the distal radius and ulna are benign yet locally aggressive bone lesions that pose significant challenges due to their high recurrence rates and the critical functional role of the wrist and forearm. Effective management requires a careful balance between achieving complete tumor excision to minimize recurrence and preserving as much wrist and forearm function as possible. Treatment strategies range from extended curettage with adjuvants for less aggressive tumors to wide resection and complex reconstruction for advanced cases. Emerging therapies such as denosumab have improved preoperative tumor control and surgical outcomes. Long-term follow-up is essential to detect and manage recurrences early. A multidisciplinary approach tailored to the individual patient’s tumor characteristics and functional demands offers the best chance for optimal oncological control and preservation of limb function.