All the information that is contained here is from Bonetumor.org

I want to help in informing people about this specific tumor and how it slowly changed my life.

Giant Cell Tumor of Bone

.Giant cell tumor accounts for 5 to 9 percent of all primary bony tumors and may be the most common bone tumor in the young adults aged 25 to 40. Giant cell tumor is are found more commonly in women than men, and occur most often during the third decade (1). Giant cell tumors are usually found in the long bones, most often the distal femur, proximal tibia, and distal radius. Giant cell tumor is a one of the most common primary bone lesions in the distal phalanx. Whether that tumor arises in the epiphysis or distal metaphysis is a matter of controversy, but giant cell tumors only occur after the epiphyseal plates have closed and a diagnosisof GCT in a patient with open growth plates should be questioned.

Most patients present with slowly progressive pain, with or without a mass. Symptoms arise when the lesion begins to destroy the cortex and irritate the periosteum or when the weakening of the bone caused by the tumor causes pain due to imminent pathologic fracture. Some giant cell tumors present with a pathologic fracture.

Giant cell tumor of bone is a benign lesion that is a usually solitary and locally aggressive. It is believed by some to be potentially malignant. In the very rare instances this lesion has the potential for metastasis to the lungs and in these cases the lung lesions may behave in an indolent fashioned and even require no treatment. The authors recommend a chest CT scan for all patients newly diagnosed with GCT

Radiologic findings demonstrate the lesion is most often eccentrically placed to the long axis of the bone. The center is most radiolucent with increasing density towards the periphery. There is a well-defined in defect in the metaphysis and epiphysis, with destruction of the medullary cavity and adjacent cortex. The destruction may stop just short of the joint. Intact borders and a sharp inner margin may be associated with a better prognosis. These tumors often thin the cortex, and may expand into the soft tissues surrounding the bone,or they may expand the the bone extensively, remaining within an eggshell-thin rim of periosteal new bone.

The gross appearance of the giant cell tumor is pain and, firm, and homogeneous, with foci of hemorrhage or necrosis. Microscopically, there are numerous multinucleated giant cells. The stromal cells are homogeneous mononuclear cells with around or ovoid shapes, large nuclei and indistinct nucleoli. The nuclei of the stromal cells are identical to the nuclei in the giant cells, a feature that distinguishes giant cell tumors from other lesions that also contained giant cells. Another feature of giant cell tumor is that the giant cells may contain very large numbers of nuclei, often several hundred. In some tumors, the giant cells can be seen to be engulfing more nuclei from the stroma.

Treatment of giant cell tumors is by surgery only. Intralesional excision by "extended" curettage is the treatment of choice. Curettage alone is associated with a high recurrence rate, and this can be decreased with the addition of chemical cautery using phenol, multiple freeze-thaw cycles using liquid nitrogen, and treating the walls of the cavity with a high-speed rotary burr. Local recurrence after curettage alone is thought to lead to recurrence in 50% of cases. Recurrence after extended curettage is approximately 10 percent.

The tumor cavity may be filled with polymethyl methacrylate cement or bone graft, according to the surgeon's preference. Some believe that the polymethyl methacrylate cement lowers the risk of a local recurrence due to the large amount of heat given off during hardening. Recurrences are normally treated with a second interlesional surgery. Bone graft may allow for more favorable biomechanics of load inthe nearby joint. The early signs of local recurrence may be more difficult to detect in cases treated with bone graft.

Lesions that are highly expansile and destructive, or lesions that occur in "expendable" bones such as the proximal fibula (shown here) may be excised with a wide margin. Multiply recurrent giant cell tumors are also treated with wide resection. Giant cell tumor may occur in the sacrum, a site where complete surgical excision is very difficult. Intralesional removal of as much of the lesion as possible followed by radiation to the tumor site has been associated with acceptable tumor control. There is concern about secondary malignancy arising in irradiated giant cell tumors. A variety of reconstructive methods are utilized depending on the extent of bony defect, or no reconstruction may be necessary. Chemotherapy is not used.

Following surgery, patients should be made aware of the ongoing risk of local recurrence. Patients should be followed on a regular basis for the first 2 years at least. Local recurrence of giant cell tumor should trigger a complete workup including CT scan of the chest, abdomen and pelvis.

References:

Gielis: GCT

Huvos Orthopedic Pathology

Bullough Orthopedic Pathology

HD4/6/2003

 

 

working in a place that you really do not enjoy is hard. you may have some friends to help you out but all-in-all it is difficult especially if there is a problem with the organization. the company i am currently working for is not yet that established or organized in the sens of ranking and the responsibilities each person has is questionable. there may be some time where all of us would be working and other times when only the two members of the marketing team (we are actually 4 people in a team ) are working and the other two are not especially the other poerson who likes to pass her responsibility to other people. any way my plans for now are to work hard here and help out my family and find a better job compared to this one which i would feel that i am neededd and not taken for granted. the ranking is also a problem because the people here take into consideration how long you have been with the company not with the results you have given. i may be doing  only 80% of my best but i am doing my job as best as i could and finish it before the schedule. but somehow this person just keeps on dragging others behind her and she has a very difficult way of thinking when it comes to work. she is nice to have as a friend but whe it comes to work she is utterly chaotic and it affects her team mates and i think she enjoys affecting others. anyway just wanted to stop by and post some things while i'm doing some stuff here. see you guyz.

Hey guyz! SOrry wasn't able to write anything down here or wasn't able to visit you guys 'coz I've been quite busy with work and some other family stufff that you would not be interested in. Any way I'm back and kicking I've put up an article about bone tumor specifically giant cell tumor because i had one and i am still fighting with it. so i hope that you get to read the article on that and that i do not own anything about the article it is from bonetumor.org and i reallly respect them that they have such information about bone tumors. Ok guys so i'll end it here.

I'm working as a junior recruiter/marketing assistant for an agency in asia. and being a junior recruiter i screen people who are applying for a call center agent position. i speak with them on the phone and i try and study if their communication skills are ok. if they have experience with regard to selling then i coordinate with my immediate superior and ask her if this person is ok and then endorse that person to a call center that handles outbound calls which would involve sales and telemarketing. what i never knew was te way they handled people who we endorse to them. I'm am utterly shocked to find out how they degrade those people who were sent over., they shout insults at them, throw things at them and they  even hit them (physically)! Where in the world could you find a work place that have these kind of people to work with? what the hell is going on here? also when we endorse them to the call center our names are the ones whom they look for because we were the one who interviewed them. and why the hell is that company doing these things to the people without us even knowing. I've been working with this company for only two months and i found out that my name is being dragged in muck because the candidates that were endorsed were not treated well. what the hell can you expect from the people who unknowingly thought that they were being sent over to a good call center with good pay. workin gin the real world is really tough because you get to meet different kinds of people, you make mistakes but you MUST learn from it and never make the same mistake again. it is really hard in the real world and if you don't do your best you'll sink.

I am here working in this small outsourcing company and e-commerce company that also offers  4 different websites alumni.net, smartshopper.net, travelsmart.net and jobscity.net. this company is outsourcing people or applicants for a career in the call center industry. One of the call center that the company is helping out is Convergys, a major call center here in the Philippines. THere are also 2 other call centers iPMAC, PCMALL, Blue Media and other call centers.
A lot of people are applying to call centers because of the good compensation and a person's communication skill is greatly improved.

ANyone here want to apply to a call cneter located in the Philippines? just post here. If you have questions and i may help post!

i've always dreamt about snakes.
but i've always dreamed about these reptiles since i was a kid and it keeps following me whereever i went. I even climbed up a very high wooden post and dangled on the metal wire and the snake stretched itself just to reach me. it didn't even stickor wrap its body on the post but just stretched and tried to bite me. these dreams were not that enjoyable.

I'm still hungry!
I just ate my lunch of ham and egg with rice nd I'm still hunry. Everytime that I'm here at the office I get hungry becaus eof all the things that I need to do and the calls AI receive. It is a bit hard but I think I'm beginning to like it here. Chocolate cake is really good too especially if the cing is just right, not too sweet.

It's been a month, and I'm working as a marketing assistant for a e-commerce compay here in Makati. I feel like I'm a bit bored withthe routine work but it seems that I will get used to this line of work and be able to develop my skills in better communicating with different people. It is fun having to talk with a lot of people, but not  that exciting because some of them are not that great to talk to. But since I'm learning the tricks of the trade I can't fully tell that I know how to talk and get along with people. I want to enhance my communiaction skills and be able to talk confidently infront of other people and have the courage to face every task with a smile or take it as a challenge. I'm getting used t the atmosphere and I wish thtta I do get to stay here for some time and then if I feel that they do not need my services anymore I will try my tricks elsewhere. But for now, I thank the Lord for giving me this big opportunity to learn how hard  real life is compared to the life in school. It takes a toll on you and you must be able to accept everything that is coming.

Creating a web journal is kind of fun and exciting at the same time 'coz you don't know who'll be viewing it and what their comments will be.

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