Multiple Giant-cell Tumour of Bone

The occurrence of more than one giant-cell tumour of bone in the same person (that is, the appearance of the tumour otherwise than as a solitary lesion) is so unusual that one accepts only with great hesitation an apparent instance of this; such a case must be carefully scrutinised to eliminate hyperparathyroidism. Jaffe (1958) observed a case ofgiant-cell tumour involving the lower end of an ulna, the fifth metacarpal bone, the proximal phalanx of the ring finger and, perhaps, the upper end ofthe humerus. He found two other patients mentioned in the literature, one with two independent giant-cell tumours in a talus and in the adjacent navicular bone, the other, reported by Coley, in which lesions developed in both femora. Coley (1949) concluded that rare reports of multiple lesions are probably instances of osteitis fibrosa cystica generalisata with tissue resembling giant-cell tumour. He found one case in which both femora were involved, already mentioned by Jaffe, and observed that on several occasions the condition extended across a joint to involve the other bone, for instance tibia to fibula and femur to acetabulum. In their series of patients with giant-cell tumour of bone, Spjut, Dorfman, Fechner and Ackerman (1971) did not report any case with a tumour in more than one place. It was the same in the review by Mnaymneh, Dudley and Mnaymneh (1964) and by Erens (1971) who studied the series of the Netherlands Committee on Bone Tumours. Goldenberg, Campbell and Bonfiglio (1970) reviewed 299 giant-cell tumours of which 218 fulfilled the criteria for full analysis. They found 222 lesions in 218 patients. This confirms the conclusion of the other authors, that multiple localisation of the tumour is extremely rare. This paper reports a patient in whom multiple giant-cell tumours of bone developed, each at a different time.