Giant Cell Tumour of Bone: A Comprehensive Review of Clinical Presentation, Diagnosis, and Management
DOI:
10.29303/jbt.v26i4.13267Published:
2026-09-29Downloads
Abstract
Giant cell tumor of bone (GCTB) is a primary bone tumor generally classified as benign but characterized by locally aggressive behavior, progressive bone destruction, functional impairment, pathological fractures, and a risk of recurrence. This review aimed to provide a comprehensive overview of GCTB by integrating its epidemiological characteristics, molecular mechanisms, clinical manifestations, diagnostic approaches, and management strategies. This study employed a literature review design using relevant scientific literature from journal articles, reviews, books, and other scientific sources. The findings indicate that the biological behavior of GCTB is closely associated with neoplastic stromal cells, molecular alterations involving H3F3A, and the receptor activator of nuclear factor kappa-B ligand (RANKL) pathway, which promotes osteoclast-like giant cell formation and osteolytic bone destruction. Diagnosis requires the integration of clinical findings, radiological evaluation, histopathological examination, and molecular approaches in selected cases. Management strategies should be tailored to lesion characteristics and may include intralesional curettage, en bloc resection, and denosumab therapy, particularly for unresectable, recurrent, metastatic, or surgically challenging cases. This review highlights the interconnected relationship between the molecular basis, clinical presentation, diagnosis, and management of GCTB, providing an integrated perspective that may support appropriate tumor control while preserving patient function and potentially reducing the burden associated with recurrence and repeated interventions.
Keywords:
Diagnosis Giant cell tumor of bone GCTB Management Osteolysis RANKLReferences
Alshaygy, I. S., Daher, M., Nahle, T., Visgauss, J. D., Brigman, B., & Eward, W. C. (2026). The association between perioperative denosumab and local recurrence after surgical management of giant cell tumors: A meta-analysis. The Journal of Bone and Joint Surgery. American Volume, 108(8), 564–571. https://doi.org/10.2106/JBJS.25.01058
Amri, R., Ayedi, M., Aifa, S., & Keskes, H. (2025). Surgical approaches for the treatment of giant cell tumor of bone in Tunisian patients: Association with recurrence. Libyan Journal of Medicine, 20(1), 2494885. https://doi.org/10.1080/19932820.2025.2494885
Borkowska, A. M., Szumera-Ciećkiewicz, A., Szostakowski, B., Pieńkowski, A., & Rutkowski, P. L. (2022). Denosumab in giant cell tumor of bone: Multidisciplinary medical management based on pathophysiological mechanisms and real-world evidence. Cancers, 14(9), 2290. https://doi.org/10.3390/cancers14092290
Campanacci, M., Baldini, N., Boriani, S., & Sudanese, A. (1987). Giant-cell tumor of bone. The Journal of Bone and Joint Surgery. American Volume, 69(1), 106–114. https://doi.org/10.2106/00004623-198769010-00018
Carneiro, B. D., Brilhante, S., Faria, C. S., Fonseca, S., & Pozza, D. H. (2026). Giant cell tumor of bone: Biology, pathophysiology, and histopathology in the era of H3F3A. Biomedicines, 14(2), 449. https://doi.org/10.3390/biomedicines14020449
Errani, C., Tsukamoto, S., Leone, G., Righi, A., Akahane, M., & Tanzi, P. (2021). Current concepts in the treatment of giant cell tumor of bone. Journal of Orthopaedic Surgery and Research, 16(1), 1–11. https://doi.org/10.1186/s13018-021-02196-7
Hosseinzadeh, S., Tiwari, V., & De Jesus, O. (2026). Giant cell tumor (osteoclastoma). In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559229/
Klenke, F. M., Wenger, D. E., Inwards, C. Y., Rose, P. S., & Sim, F. H. (2017). Giant cell tumor of bone revisited. SICOT-J, 3, 54. https://doi.org/10.1051/sicotj/2017041
Lin, J.-L., Wu, Y.-H., Shi, Y.-F., Lin, H., Nisar, M., Meftah, Z., Xu, C., Chen, J.-X., & Wang, X.-Y. (2019). Survival and prognosis in malignant giant cell tumor of bone: A population-based analysis from 1984 to 2013. Journal of Bone Oncology, 19, 100260. https://doi.org/10.1016/j.jbo.2019.100260
Maulida, A. I., Ramzi, A., Muliawan, A. H., Kayla, B. G., Nadila, C., Salsabila, D., et al. (2023). Giant cell tumor of bone: Pathogenesis and clinical manifestation. Jurnal Biologi Tropis, 23(4b), 193–199.
Nishio, J., Nakayama, S., Koga, K., & Aoki, M. (2024). Giant cell tumor of soft tissue: An updated review. Journal of Clinical Medicine, 13(10), 2870. https://doi.org/10.3390/jcm13102870
Noh, B.-J., & Park, Y.-K. (2018). Giant cell tumor of bone: Updated molecular pathogenesis and tumor biology. Human Pathology, 81, 1–8. https://doi.org/10.1016/j.humpath.2018.06.017
Palmerini, E., Picci, P., Reichardt, P., & Downey, G. (2019). Malignancy in giant cell tumor of bone: A review of the literature. Technology in Cancer Research & Treatment, 18, 1533033819840000. https://doi.org/10.1177/1533033819840000
Pitsilos, C., Givissis, P., Papadopoulos, P., & Chalidis, B. (2023). Treatment of recurrent giant cell tumor of bones: A systematic review. Cancers, 15(13), 3287. https://doi.org/10.3390/cancers15133287
Schoutens, C., & Verspoor, F. G. M. (2023). Heat treatment for giant cell tumors of bone: A systematic review. Journal of Orthopaedic Surgery, 31(3), 10225536231202157. https://doi.org/10.1177/10225536231202157
Tsukamoto, S., Mavrogenis, A. F., Kido, A., & Errani, C. (2021). Current concepts in the treatment of giant cell tumors of bone. Cancers, 13(15), 3647. https://doi.org/10.3390/cancers13153647
Tsukamoto, S., Mavrogenis, A. F., Masunaga, T., Honoki, K., Fujii, H., Kido, A., Tanaka, Y., & Errani, C. (2024). Current concepts in the treatment of giant cell tumor of bone: An update. Current Oncology, 31(4), 2112–2132. https://doi.org/10.3390/curroncol31040157
van der Heijden, L., Dijkstra, P. D. S., van de Sande, M. A. J., Kroep, J. R., Nout, R. A., van Rijswijk, C. S. P., & Gelderblom, H. (2014). The clinical approach toward giant cell tumor of bone. The Oncologist, 19(5), 550–561. https://doi.org/10.1634/theoncologist.2013-0432
van der Linde, R. M., van IJzendoorn, D. G. P., van de Rijn, M., & Bovée, J. V. M. G. (2026). Giant cell-rich tumors of bone and soft tissue. Modern Pathology, 39(1), 100915. https://doi.org/10.1016/j.modpat.2025.100915
Zhong, J., Xing, Y., Zhang, G., Hu, Y., Ding, D., Ge, X., Pan, Z., Yin, Q., Zhang, H., Yang, Q., Zhang, H., & Yao, W. (2023). A systematic review of radiomics in giant cell tumor of bone (GCTB): The potential of analysis on individual radiomics feature for identifying genuine promising imaging biomarkers. Journal of Orthopaedic Surgery and Research, 18(1), 414. https://doi.org/10.1186/s13018-023-03863-w
License
Copyright (c) 2026 Huriyah Nabilah Zhahirah, Azka Fadila Latifa, Muhammad Fatih Ma'ruf, Novad Sawelly, Annisa Fitria Zahra AS, Fidelya Fitria Hakim, I Wayan Putra Kesumantara Wiguna, Sheilla Ninditya Putri, Baiq Tasyfa Hasya Auliya Tsaniya, Firman Khalif Yuwono, Maratun Shulha, Siti Fadilah

This work is licensed under a Creative Commons Attribution 4.0 International License.

Jurnal Biologi Tropis is licensed under a Creative Commons Attribution 4.0 International License.
The copyright of the received article shall be assigned to the author as the owner of the paper. The intended copyright includes the right to publish the article in various forms (including reprints). The journal maintains the publishing rights to the published articles.
Authors are permitted to disseminate published articles by sharing the link/DOI of the article at the journal. Authors are allowed to use their articles for any legal purposes deemed necessary without written permission from the journal with an acknowledgment of initial publication to this journal.























