Bifocal metachronous giant-cell tumour of ulna and distal radius

A 36 years old gentleman had giant cell tumour (GCT) in distal ulna for which he underwent resection of distal half of ulna but developed recurrence of the tumour. Following proper evaluation (grading and staging), he underwent wide margin excision of tumour including removal of distal three-fourth of ulna and reconstruction by free vascularised osteocutaneous fibular transfer. The distal reconstructed fibula was stabilized with extensor carpi ulnaris (ECU). Two years after the surgery, he developed a metachronous GCT lesion in ipsilateral distal radius for which he had curettage and bone grafting with preservation of articular surface.