Introduction. Giant cell tumors (GCTs) of bone are known for their local aggressiveness and high recurrence rate. There are rare cases of multicentric GCT and most are synchronous. We herein review metachronous multicentric GCT reported in the literature. Material and Methods. A MEDLINE, Cochrane, and Google Scholar search was done to collect all cases of multicentric metachronous GCT specifying the clinical, radiological, and histological characteristics of each location and its treatment. Results. A total of 37 multifocal giant cell tumors were found in the literature. 68% of cases of multicentric giant cell tumors occur in less than 4 years following treatment of the first lesion. Thirty-seven cases of multifocal metachronous GCT were identified in the literature until 2012. Patients with multicentric GCT tend to be younger averaging 23. There is a slight female predominance in metachronous GCT. The most common site of the primary GCT is around the knee followed by wrist and hand and feet. Recurrence rate of multicentric GCT is 28.5%. Conclusion. Multicentric giant cell tumor is rare. The correct diagnosis relies on correlation of clinical and radiographic findings with confirmation of the diagnosis by histopathologic examination. 1. Introduction Giant cell tumors (GCTs) of bone are known for their local aggressiveness and high recurrence rate. Patients with GCT present with nonspecific symptoms including pain, overlying soft-tissue swelling, and decreased range of motion at the adjacent joint [1]. They rarely metastasize to distant structures such as the lung, although these metastases generally have the same benign histologic appearance as the index tumor [2]. Even rarer are cases of multicentric giant cell tumor. Most multicentric giant cell tumors are synchronous, that is, occurring within a poorly defined time of the initial tumor [3]. In this paper, we present the case of a metachronous giant cell tumor as well as a review of the literature of metachronous multicentric giant cell tumor. 2. Case Report An 18-year-old female presented to our institution with inflammatory right elbow pain and elbow stiffness. X-rays showed a lucent image on the medial aspect of the right distal humeral metaphysis with a radiologically intact cortex (Figure 1). Histological diagnosis of GCT was made on open biopsy. Extensive curettage was undertaken, phenol was applied on the walls of the remaining cavity as well as high-speed burring, and the cavity was filled with methyl methacrylate, with a satisfying result. Figure 1: AP view of the elbow with radiolucent
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