Giant Cell Tumour of Bone: A Comprehensive Review of Clinical Presentation, Diagnosis, and Management

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.