A previously healthy, 26-year-old female presented with a 2-year history of right 5th toe pain and progressive swelling, but walked well with normal gait. Radiographs revealed expansile geographic osteolytic lesions of the proximal phalanx of the right 5th toe (Fig. 1). Open biopsy confirmed a diagnosis of GCTB. No distant metastasis was detected. She did not take medication regularly and denied family history of genetic disorders. Patient understood her health condition and agreed to undergo wide resection and reconstruction with customized, 3D-printed toe prosthesis after critical discussion of possible methods of treatment. Denosumab was not administered preoperatively.