{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T13:38:46Z","timestamp":1793367526773,"version":"4.5.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Giant cell tumor (GCT) of bone is a benign but locally aggressive tumor, commonly found around the knee in young adults. Despite surgical excision, GCTs are known for their high recurrence rates, prompting the use of adjuvant therapies such as cryotherapy. Liquid nitrogen is a widely used cryoablation agent but carries the risk of complications including skin necrosis, nerve injury, and pathological fractures. A newer agent, freezing nitrogen ethanol composite (FNEC), has emerged as a potentially safer alternative with similar tumoricidal effects and fewer side effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation:<\/jats:title>\n                    <jats:p>A 37-year-old man presented with a progressively enlarging, painless lump on his left knee that had been present for 5 years. Physical examination revealed a firm, non-tender mass the size of a tennis ball. Imaging studies suggested a GCT, and a preoperative biopsy confirmed a diagnosis of tenosynovial GCT. The patient underwent intralesional curettage followed by cryotherapy using FNEC as an adjuvant. To support structural integrity post-curettage, internal fixation with a plate and screw was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>FNEC acts through several mechanisms including cell shrinkage, DNA fragmentation, and induction of apoptosis. Compared to liquid nitrogen, FNEC appears to provide a more controlled cryogenic effect with less risk of injury to surrounding tissues. In this case, no complications were observed during recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>FNEC may offer a safer and effective cryotherapy option for GCT management. Further clinical research is needed to confirm its long-term safety and efficacy compared to traditional methods.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/rc9.0000000000000020","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T09:00:54Z","timestamp":1772442054000},"page":"1184-1188","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Freezing nitrogen ethanol composite as an alternative to liquid nitrogen in giant cell tumor cryotherapy: a case report and literature review"],"prefix":"10.1097","volume":"138","author":[{"given":"Alvian","family":"Andriyanto","sequence":"first","affiliation":[{"name":"Department of Orthopaedic and Traumatology, Universitas Padjadjaran, Bandung, West Java, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Naseh Sajadi","family":"Budi Irawan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Traumatology, Universitas Padjadjaran, Bandung, West Java, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bangkit","family":"Primayudha","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Traumatology, Universitas Padjadjaran, Bandung, West Java, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"R1-20261030","first-page":"1650\u201363","article-title":"Freezing Nitrogen Ethanol Composite May be a Viable Approach for Cryotherapy of Human Giant Cell Tumor of Bone","volume":"475","author":"Po Kuei","year":"2017","journal-title":"Clin Orthop Relat Res"},{"key":"R2-20261030","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1051\/sicotj\/2017041","article-title":"Giant cell tumor of bone revisited","volume":"3","author":"Mavrogenis","year":"2017","journal-title":"SICOT J"},{"key":"R3-20261030","doi-asserted-by":"crossref","first-page":"228\u201331","DOI":"10.1177\/1602400221","article-title":"Wide resection versus curettage with adjuvant therapy for giant cell tumour of bone","volume":"24","author":"Kamal","year":"2016","journal-title":"J Orthop Surg"},{"key":"R4-20261030","doi-asserted-by":"crossref","first-page":"3287","DOI":"10.3390\/cancers15133287","article-title":"Treatment of recurrent giant cell tumor of bones: a systematic review","volume":"15","author":"Pitsilos","year":"2023","journal-title":"Cancers (Basel)"},{"key":"R5-20261030","doi-asserted-by":"crossref","first-page":"36332","DOI":"10.1038\/srep36332","article-title":"Recurrence rates and risk factors for primary giant cell tumors around the knee: a multicentre retrospective study in China","volume":"6","author":"Hu","year":"2016","journal-title":"Sci Rep"},{"key":"R6-20261030","doi-asserted-by":"crossref","first-page":"3721","DOI":"10.3889\/oamjms.2019.731","article-title":"Efficacy of Minimally Invasive Surgery on Giant Cell Tumour of the Bone: A Systematic Review","volume":"7","author":"Deslivia","year":"2019","journal-title":"Open Access Maced J Med Sci"},{"key":"R7-20261030","doi-asserted-by":"crossref","first-page":"332\u201338","DOI":"10.1097\/CCO.0000000000000645","article-title":"Current concepts in the treatment of giant cell tumour of bone","volume":"32","author":"van der Heijden","year":"2020","journal-title":"Curr Opin Oncol"},{"key":"R8-20261030","doi-asserted-by":"crossref","first-page":"957\u201369","DOI":"10.1002\/1097-0142(197803)41:3<957::AID-CNCR2820410325>3.0.CO;2-Y","article-title":"Cryosurgery in the treatment of giant cell tumors of bone. A report of 52 consecutive cases","volume":"41","author":"Marcove","year":"1978","journal-title":"Cancer"},{"key":"R9-20261030","doi-asserted-by":"crossref","first-page":"13\u201317","DOI":"10.1016\/j.jbo.2017.04.002","article-title":"Postoperative complications with cryotherapy in bone tumors","volume":"7","author":"Chen","year":"2017","journal-title":"J Bone Oncol"},{"key":"R10-20261030","first-page":"64\u201369","article-title":"Perioperative complications of using freezing nitrogen ethanol composite to treat bone tumors: Clinical experience from a single center","volume":"87","author":"Chen","year":"2024","journal-title":"J Chin Med Assoc"},{"key":"R11-20261030","doi-asserted-by":"crossref","first-page":"34\u201339","DOI":"10.1016\/j.cryobiol.2018.06.008","article-title":"A safety comparative study between freezing nitrogen ethanol composite and liquid nitrogen for cryotherapy of musculoskeletal tumors","volume":"83","author":"Chen","year":"2018","journal-title":"Cryobiology"},{"key":"R12-20261030","first-page":"2025","article-title":"Revised Surgical CAse REport (SCARE) guideline: An update for the age of Artificial Intelligence","volume":"10","author":"Kerwan","year":"2025","journal-title":"PJS"},{"key":"R13-20261030","first-page":"2","article-title":"Giant cell tumor of bone-an overview","volume":"4","author":"Sobti","year":"2016","journal-title":"Arch Bone and Joint Surg"},{"key":"R14-20261030","doi-asserted-by":"crossref","first-page":"495\u2013501","DOI":"10.1007\/s13277-015-3094-y","article-title":"RANK pathway in giant cell tumor of bone: pathogenesis and therapeutic aspects","volume":"36","author":"Wu","year":"2015","journal-title":"Tumor Biol"},{"key":"R15-20261030","article-title":"Giant cell tumour of bone: A comprehensive review of pathogenesis, diagnosis, and treatment","volume":"15","author":"Jha","year":"2023","journal-title":"Cureus"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/RC9.0000000000000020","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T13:03:20Z","timestamp":1793365400000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/RC9.0000000000000020"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,24]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/rc9.0000000000000020","relation":{},"ISSN":["2210-2612","2210-2612"],"issn-type":[{"value":"2210-2612","type":"electronic"},{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2,24]]},"assertion":[{"value":"2025-08-13","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-16","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}