Table 1: Analysis of all metachronous multicentric GCT.

AuthorNo. of casesAge at diagnosis/sexFirst locationTreatment undergoneTime between 1st and 2nd GCTSecond locationTreatment undergoneFollowupDuration

Kimball and Desanto (1958) [5]139/FLeft distal ulnaUlna resection4 y(1) Right distal humerus
(2) Frontal bone
(3) Lung metastases
Biopsy and curettage
Intensive radiotherapy
Death3 mo
Jacobs (1972) [6]120/MProximal tibiaRadiotherapy9 yRight acetabulumCurettageN/AN/A
Sybrandy and de la Fuente (1973) [7]153/FLeft distal femurExcision, autoclaving, and then reimplantation of the bone2 yTrochanteric area of the right femur Removal of tumor + arthrodesis of hip + radiotherapy (6000 cGy) Good general condition, walks with crutchesN/A
Tornberg et al. (1975) [8]135/MR proximal fibulaExcision + iliac bone graft2 yRight tibial plateau + left proximal fibulaEn bloc resection Independent + pain-free3 y
Sim et al. (1977) [9] 920/ML distal femurCurettage + bone graft(1) L proximal tibia/L distal tibia
(2) L distal ulna
(3) Recurrence in L proximal tibia
(1) Curettage/observation
(2) Resection
(3) Amputation
Disease-free 23 mo
21/FL lower cuneiformBelow knee amputation16 yL1 vertebraExcision + anterior fusionGood 5 y
29/FL proximal tibiaCryotherapy + curettage + bone graft2 yL distal femurCurettage + graftDisease-free 10 mo
24/ML distal ulnaCurettage and then resection2 y
5 y
11 y
(1) L prox humerus
(2) C3
(3) R distal ulna
(1) Resection + hemiarthroplasty
(2) Radiotherapy + fusion
(3) Resection
Disease-free 25 y
21/FR proximal humerusResection with Neer prosthesis 2 yR proximal iliumResectionDisease-free8 y
19/FSphenoidSubtotal excision + radiotherapy3 mo(1) R proximal tibia
(2) L distal radius
(1) Curettage + bone graft
(2) Curettage + bone graft
Disease-free, severe neurologic sequelaeN/A
21/FL distal radiusCurettage + bone graft10 moL proximal radiusCurettageDisease-free 15 mo
Peimer et al. (1980) [10] 530/MR ulnar headEn bloc resection11 y
12 y
(1) R olecranon
(2) Carpal + metacarpal bones
(1) Curettage + graft
(2) En bloc resection
20/FL proximal 4th phalanxCurettage + graft7 y(1) L 3rd phalanx
(2) L proximal humerus
(1) Curettage + graft
(2) Curettage + graft
Recurrence in phalanx → hand amputationN/A
17/FR tibiaCurettage + graft10 moL halluxCurettageDisease-freeN/A
18/FL radiusResection + graft3 yR 1st distal phalanxSubtotal amputationDisease-freeN/A
Rock et al. (1984) [11]150/ML tibiaCurettage + graft then amputation for recurrence10 y(1) Pelvis
(2) Scalp
(3) Lung
(doxorubicin + cyclophosphamide)
Death1 y
Williams (1989) [12]126/ML distal femurAbove knee amputation (associated with osteomyelitis)16 yL proximal femur (pathological fracture) + R iliac wingResection of the proximal femur CurettageN/AN/A
Ogihara et al. (1994) [2]129/FL proximal humerusCurettage + bone grafting and then en bloc resection for recurrence20 yRight proximal humerus Curettage, cryotherapy, and bone graft and then en bloc resection for recurrenceDisease-freeN/A
Hindman et al. (1994) [13] 522/MP1 of the L ring fingerCurettage + grafting3 yR calcaneum + metastatic lung disease + L fibula + R radiusBelow R knee amputation + resection of the lung lesionRecurrence in the L calcaneum N/A
17/FR proximal humerusCurettage + grafting4 yR distal radiusCurettage + bone graft Recurrence in R distal radius 23 y (treatment N/A)
10/FL distal femurPacking with bone graft6 yL proximal tibiaResection of the proximal tibia/distal femur + prosthesisN/AN/A
27/MDistal radiusN/A15 yDistal humerus (same arm)Curettage + PMMAN/AN/A
Bacchini et al. (1995) [14]122/FR distal femurCurettage + autologous bone graft2 y
7 y
(1) R distal femur, proximal femur, and proximal fibula
(2) + R distal tibia
(1) Observation
(2) Curettage + graft + cement (proximal tibia)/curettage + graft (distal tibia)
Cummins et al. (1996) [15] 516/FR talusCurettage + autologous bone graft3 y(1) R distal tibia
(2) R medial tibial plateau
(1) Below knee amputation
(2) Above knee amputation
Disease-free12 y
22/MR fibular headEn bloc resection 2 yR distal femurCurettage + PMMADisease-free7 y
14/FL proximal tibiaCurettage + autologous graft 2 yR occipital lesion Radiotherapy + chemotherapyDisease-free16 y
18/ML distal femurCurettage + autologous graft2 y
5 y
(1) R proximal tibia
(2) Humeral head (R + L)
(1) Curettage + graft and then resection + knee arthrodesis for recurrence
(2) Curettage + graft
Lost to followup
Park et al. (1999) [4]125/ML distal ulnaResection of the distal segment of the ulna 10 yL proximal ulna Curettage + bone chips fillingRecurrence at 2 y → total removal L ulnaN/A
Mondal et al. (2001) [16]110/MR proximal humerusCurettage + graft4 yR proximal tibiaCurettage + PMMADisease-free5 y
Taylor et al. (2003) [17]113/M L proximal tibiaExcisional biopsy, curettage, burring, and phenol application + PMMA23 mo
28 mo
31 mo
40 mo
42 mo
52 mo

68 mo
(1) L distal tibia
(2) L femoral head
(3) L lateral femoral condyle
(4) L patella
(5) L distal tibia
(6) L distal tibia, recurrence/fracture
(7) L proximal fibula
(1) Curettage, phenol, nitrogen, and PMMA
(2) Curettage, PMMA
(3) Curettage, PMMA
(4) Curettage, PMMA
(5) Curettage, nitrogen, and PMMA
(6) Resection, bone transport, and arthrodesis
(7) Resection, ligamentous reconstruction
Haskell et al.(2003) [18]123/FR proximal tibiaResection of proximal tibia + arthrodesis (allograft autologous graft)24 yL iliac wing near the sacroiliac joint Extensive curettage + 3% hydrogen peroxide solution + reconstruction with PMMA + pinsDisease-free3 y
Rousseau et al. (2004) [19]119/FR distal femurCurettage + autologous bone graft4 y
16 y
20 y
21 y
(1) R proximal tibia
(2) R distal tibia + fibula
(3) Recurrence in R proximal tibia + R distal fibula
(4) Recurrence in R proximal tibia
(1) Curettage + autologous bone grafting
(2) Curettage + PMMA
(3) Curettage + PMMA
(4) Curettage + PMMA
Stratil and Stacy (2005) [1]115/ML fibular headPartial fibulectomy + curettage1 yL distal tibia SacrumCurettage + bone graft + PMMA Curettage, decompression + spinal fusion ChemotherapyDisease-freeN/A
McKinney et al. (2006) [20]144/FR pelvic lesionCurettage + autologous bone graft15 ySphenoid boneSubtotal resection of the sphenoid bonePersistence of sphenoid + iliac lesions3 mo
Zahid et al. (2010) [21]115/FR 4th metacarpal boneResection + reconstruction with fibular graft18 mo
4 y
(1) 3rd + 5th metacarpal bones
(2) R distal humerus
(1) Resection + reconstruction with fibular graft
(2) Resection + arthrodesis
Yazdi et al. (2012) [22]119/FR distal radiusResectionN/A(1) L proximal + middle humerus
(2) R sacral lesion
(3) Nasopharynx/pterygoid
(1) Resection + prosthesis
(2) Embolisation, debulking, and radiation therapy
(3) Debulking, radiation therapy
Disease-free1 y
This case 118/FR distal humerusCurettage + phenol + PMMA and then elbow resection + elbow arthroplasty for recurrence11 yL iliac boneCurettage + phenol + alcohol + PMMADisease-free1 y

F: female, Mo: months, L: left, N/A: not available, M: male, and PMMA: Polymethyl methacrylate.