A 35 yr old male patient presented with complaints of pain and swelling on the distal aspect of the left leg. The patient suffered a twisting injury to the leg one year ago and had mild pain and swelling for which he took treatment from an osteopath. The pain reduced but the swelling persisted. One month ago, the swelling increased in size and was associated with severe pain which was exaggerated on walking. There was no history of fever, night cries, loss of weight, and loss of appetite present. History of massage therapy was present which was done 4-5 times.
On examination, swelling was present over the distal aspect of the leg about 6 x 4 cm with well-defined margins, smooth surface, and bony deep. The skin over the swelling was normal. Tenderness was present over distal tibia. Ankle movements were normal.
X-ray showed well-defined expansile lytic lesion at distal end of left tibia suggestive of giant cell tumor of distal end tibia. CT (Figure 1) ankle shows morphology of subarticular expansile lytic lesion in lower end of left tibia suggestive of giant cell tumor. 
The condition and routine investigations done in preparation for operative procedure were explained to the patient. Patient was treated with intralesional excision and curettage and the cavity was filled with bone cement. Specimen was sent for histopathological (Figure 2) examination which confirmed giant cell tumor. The patient was immobilised in an above knee cast for one month and converted to a PTB cast later. Sequential X-rays (Figure 3) were taken to confirm the union and cast removal was done at the end of three months postoperatively. The patient was started on regular physical therapy and was allowed weight bearing when the patient was comfortable. Patient was followed up for one year at regular intervals and the patient was ambulatory without any evidence of recurrence at the end of one year.