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I've heard that sacral tumors from giant cell myeloma comes back even after it's been surgically removed. Is that true?
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Giant cell myeloma (also called giant cell tumor of the bone) is a fairly uncommon tumor. It is called giant cell tumor because there are large bone-like cells with more than one nucleus (center).
These tumors are usually slow to develop and are benign. But because they can grow large and put pressure on nerves and blood vessels, they are often removed surgically. The recurrence rate is rather high -- 50 per cent or more.
Some experts suggest this is because of bleeding into the surgical site when the tumor is removed. Any tumor cells that spill into the open area can be carried by the blood to other parts of the body. Metastases (spread) occurs most often to the lungs.
To avoid this problem, a group of surgeons has suggested limiting intraoperative bleeding. They do this using nylon tape wrapped around the large blood vessels supplying the area being operated on. The tape slowly compresses the blood vessel until it is closed completely.
Limiting bleeding makes it possible for the surgeon to see the outline of the tumor and remove it without contaminating (spreading) tumor cells in the area. Surgical sponges can be packed around the outside of the tumor to keep any cells from spilling into the area.
At least one report using this technique reduced the rate of recurrence in the first two years to 29 per cent. Complications from surgery are still as high as 50 per cent. Problems such as deep vein thrombosis (blood clots), wound infections, or wound dehiscence (delayed wound healing with surgical site re-opening often develop. Some complications are determined by the area operated on. For example, surgical removal of giant cell tumors of the vertebrae (rare) or sacrum (uncommon) can be accompanied by cerebrospinal fluid leakage.
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