Massive giant-cell tumor of pelviacetabulum

Giant-cell tumor (GCT) of the pelvis is uncommon, accounting for only 1.5 to 6% of cases of GCT.^[1] In pelvis ilium is the most common site of involvement; ischium and pubis are less frequently involved.^[2] It typically presents in adults between age of 20 to 50 with localized swelling and pain.^[3] Females are slightly more affected than males.^[4]

Average size of the tumor in this region is 9.5 cm.^[5]

There are different modalities of treatment of pelvic GCT. Radiotherapy has high rate of recurrence (44%) and risk of soft tissue sarcomas (12%).^[6] Thus treatment should be essentially surgical which includes surgical excision. Excision can be extralesional which achieves 90% local tumor control but poor functional outcome ^[7] or it can be intralesional which has 90% local recurrence rate with good functional outcome.^[8]

Massive GCT of pelvis, which is static, not amenable to excision and presenting with mechanical symptoms, can be managed by de-bulking the portion of tumor responsible for mechanical symptoms. And patients need to be followed for local invasion or metastasis.^[9]