giant cell tumour of bone ( gct ) is a common benign primary bone tumour , seen commonly in the distal femur , proximal tibia and distal radius . we report an unusual presentation of recurrent giant cell tumour in a 25 year old male in the medial condyle and epicondyle of left humerus . as it is an uncommon site for tumors , it was misdiagnosed as tuberculous osteomyelitis and was inadequately curetted . we did en - bloc resection of the tumour , with judicious removal of partial trochlea . though reconstruction was planned , it was found to be not necessary as the elbow was stable per - operatively . there is no recurrence or metastasis of the tumor in the two - year follow - up . though bone tumors are rare in distal humerus , biopsy is needed to confirm the diagnosis of any lytic lesion in this region for proper management . giant cell tumour is a locally aggressive primary bone tumour , located eccentrically in the metaphysis and epiphysis of a long bone . it commonly affects distal end of femur , proximal end of tibia and distal end of radius . it is occasionally reported in small bones of hand and foot , spine and pelvis . though it occurs in 20 - 35 year old individuals commonly , it can also be seen in children as young as 2 years and also in older individuals . we report an unusual presentation of giant cell tumour in medial condyle and epicondyle of right humerus which mimicked tuberculosis . a 26 year old male developed pain and swelling over medial aspect of left elbow 3 years ago . x - ray showed ill - defined radiolucent lesion in the medial condyle of left distal humerus ( fig . mri showed osteolytic lesion in medial epicondyle and trochlea which was hyperintense on all the sequences . it was a well - defined lesion , and was extending into the soft tissue through a break in the medial cortex . probably because of the rarity of gct at this particular site , it was not thought of , and the lesion was suspected to be tuberculous osteomyelitis . histopathological examination showed multinucleate giant cells and spindle cells with identical nuclei and the lesion was diagnosed as gct . patient came to our institution six months after the reappearance of the swelling i.e. , one year after curettage . at the time of presentation , the elbow was in 50 of flexion and the range of motion was restricted to 50 - 90. the swelling was 4   5  in size , situated anteromedially just above the elbow joint . x - ray showed well - defined expansile osteolytic lesion in the medial epicondyle and part of the trochlea . cortical destruction was seen medially , hence the tumour was graded as grade iii giant cell tumour according to companacci grading ( fig . 2 ) . mri showed breach in the medial cortex , with the tumour extending into the soft tissue . pathological fracture of medial cortex was seen and the tumour was extending anteriorly outside the bone . enbloc resection of the tumour was done , including part of the trochlea ( fig . 4 ) . reconstruction was deferred as the joint appeared to be stable intra - operatively . post - operatively , neurovascular function was intact and the elbow was mobilized from third week post - operatively . x - ray chest and elbow taken six months , one year and two years post - operatively showed no recurrence or metastasis . the incidence of giant cell tumour is 5% among primary bone tumors , of which 3% show metastasis in lungs . though gct is a benign bone tumor , it breaches the cortex and invades the soft tissues . low degree of suspicion may be the reason for inadequate removal of the tumour during the primary surgery . giant cell tumour in upper limb is considered to be more aggressive than the tumour in lower limb . resection of the tumour involving the whole distal humerus and reconstruction with total elbow arthroplasty is also described . since the lesion is involving the trochlea only partly , resection of the tumour and supporting the medial aspect of the joint with autogenous tricortical iliac crest graft is planned . but there is no instability after resection of the tumour and elbow movement is regained completely . so , reconstruction is deferred , to be done later if it is deemed necessary . patient does nt opt for reconstruction when apart from having mild pain , patient is satisfied with the function of his left elbow . his elbow performance score has improved from 30 to 85 . as is in the case of recurrent gct patient is advised regular follow - up to detect local recurrence and metastasis at the earliest . though occurrence of gct is rare in distal humerus , it should be considered in the differential diagnosis of any radiolucent lesion .
introduction : giant cell tumour of bone ( gct ) is a common benign primary bone tumour , seen commonly in the distal femur , proximal tibia and distal radius . 
 very few cases of gct are reported in distal humerus . 
 we report an unusual presentation of recurrent giant cell tumour in a 25 year old male in the medial condyle and epicondyle of left humerus.case series : patient presented elsewhere with lytic lesion of left elbow three years ago . 
 as it is an uncommon site for tumors , it was misdiagnosed as tuberculous osteomyelitis and was inadequately curetted . 
 patient presented to us with recurrence of tumor one year after the primary surgery . 
 we did en - bloc resection of the tumour , with judicious removal of partial trochlea . 
 though reconstruction was planned , it was found to be not necessary as the elbow was stable per - operatively . 
 patient regained near normal movements of the elbow with no instability . 
 his mayo elbow performance score improved from 30 to 85 . 
 there is no recurrence or metastasis of the tumor in the two - year follow-up.conclusion:though bone tumors are rare in distal humerus , biopsy is needed to confirm the diagnosis of any lytic lesion in this region for proper management .