"A Giant Shoulder": Proximal Humerus Giant Cell Tumor Managed With Extended Curettage and Proximal Humerus Internal Locking System Plating with Fibular Strut Graft - A Case Report.

INTRODUCTION: Giant cell tumors of the bone (GCTB) are challenging neoplasms, particularly in the proximal humerus. CASE REPORT: We report the case of a 46-year-old male with proximal humerus GCTB who was managed with extended curettage, proximal humerus internal locking system (PHILOS) plating, and fibular strut grafting. The patient presented with shoulder pain and restricted movement. Imaging revealed a lytic lesion in the metaphyseal-epiphyseal region, and a biopsy confirmed the diagnosis. Extended curettage was performed using the deltopectoral approach, followed by cryotherapy and reconstruction with a fibular strut graft and PHILOS plate fixation. The patient received three post-operative doses of zoledronic acid. At the 24-month follow-up, the patient showed near-complete shoulder movement, with a disabilities of the arm, shoulder, and hand score of 20.8. Imaging revealed complete graft incorporation without any recurrence. CONCLUSION: This case demonstrates the effectiveness of extended curettage and biological reconstruction in managing proximal humeral GCTB, balancing tumor control and functional preservation.