Primary giant cell tumor of soft tissues similar to bone. The lesion most likely to be confused with a giant cell tumor is the aneurysmal bone cyst. Epidemiology of benign giant cell tumor of bone in the. Giant cell tumor of bone arising in long bones possibly originates. Although a giant cell tumor of bone is a benign tumor, it is considered to be locally aggressive and has the potential to result in local recurrence, like malignant tumors. They encompass approximately 4% to 5% 24,28 of all primary bone tumors and 21% of all benign bone tumors. The patient was treated with partial scapulectomy with complete resection of tumour. Pdf a rare case of giant cell tumor of the temporal bone. The majority of these tumors develop in patients aged. Giant cell tumor of the bone usually presents after a long course of pain caused by the tumor growth, which can also impact mechanical functioning, biermann said. Giant cell tumor of bone gctb is a benign but locally aggressive bone tumor of young adults. Because giant cell tumors destroy bone, there is risk for pathologic fracture in the area of the tumor. November 2012, a 65yearold female complained of pain left and claudication for 3 months.
Twentyfive of these 31 had previously been irradiated. Benign but locally aggressive primary bone neoplasm composed of mononuclear round to spindle cells with numerous evenly dispersed osteoclastlike giant cells. The aggressiveness and recurrence of giant cell tumor cannot be predicted from clinical and histopathological findings 16. Heat shock protein 70 expression in giant cell tumor of. Giant cell tumor gct of bone is one of the commonest benign bone tumors encountered by an orthopedic surgeon. Giant cell tumor of bone an overview abstract giant cell tumors gct are benign tumors with potential for aggressive behavior and capacity to metastasize. Giant cell tumor of the bones of the hand and foot. Radiation therapy for giant cell tumors of bone request pdf. To treat giant cell tumors, this drug is injected under the skin subq or sq. Filled with allograft andor homograft bone in during operation.
Original article ultrasonic scalpel treatment for hiv. Light microscopy showed a lesion composed of a homogeneously mixed proliferation of spindle and polygonal mononucleated stromal cells and evenly distributed multinucleated, osteoclast. Giant cell tumor of bone gctb has occupied a central stage in musculoskeletal tumor practice because of its relatively common incidence, the striking features of giant cell formation, severe bone destruction osteolysis, and the risk for jointrelated fractures in the femur and tibia. Although well defined in clinical, radiological and histological terms, detailed information on its biological development is still relatively incomplete.
Cooper in 1818 first described giant cell tumors gct of the bone 1. Although it is considered to be a benign lesion, there are still incidences of pulmonary metastasis. Although rarely lethal, benign bone tumors may be associated with a substantial disturbance of the local bony architecture that can be particularly troublesome in periarticular locations. Giant cell tumor of bone gctb usually appears as a benign tumor with local aggressiveness. Giant cell tumors gcts of the bone are locally progressive and destructive borderline malignant neoplasms, which comprise 5% of primary bone tumors and 20% of benign tumors. Pdf icon sarcoma uk factsheet giant cell sarcoma of the bone.
Pdf giant cell tumor gct of bone is generally a benign tumor composed of mononuclear stromal cells and characteristic multinucleated. Pathologic fracture is present in 510% of giant cell tumours. Giant cell tumors of bone are slightly more common in women 1. Giant cell tumor of soft tissue is genetically distinct from its bone. The authors report a case of a large giant cell tumor involving the petrous and squamous portions of the temporal bone in a 26 year old male patient. Surgery is the main treatment for giant cell tumor and. Giant cell tumor of bone is now recognized as being only one of a group of bone lesions that contain giant cells or osteoclasts. Literature on surveillance for lung metastasis from giant cell tumor of bone gctb is scarce. Giant cell tumor is a mesenchymal neoplasm, which is mainly seen in long bones1. Giant cell tumor of the bones of the hand and foot biscaglia 2000. Giant cell tumor of bone gctb comprises up to 20 % of benign bone tumors in the us. Whether that tumor arises in the epiphysis or distal metaphysis is a matter of controversy, but giant cell tumors only occur after the epiphyseal plates have closed and a diagnosisof gct in a patient with open growth plates should be questioned.
They seldom develop in the cranium and are very rare in patients older than 60 years of age. Primary malignancy in giant cell tumor of thoracic. Only 2% to 5% of all giant cell tumors occur in the hand, with a 15% incidence in the distal radius. Giant cell tumors have a recognizable pattern on xray a large, almost transparent area in the bone where the tumor has destroyed bone cells. Giant cell tumor of bone is usually a benign neoplasm with local malignant potential. Pdf giant cell tumors gct are benign tumors with potential for aggressive behavior and capacity to metastasize. Other common soft tissues masses that may occur in the foot are ganglions, fibromas. The individual strategy could be beneficial and different therapeutic methods worth to use such, as bone remodeling substances, chemotherapy, radiotherapy and maybe in the future immunotherapy.
Giant cell tumor gct of bone is a locally aggressive benign neoplasm that is associated with a large biological spectrum ranging from latent. Giant cell tumor of bone gctb is a primary benign bone tumor with a locally aggressive character. Pdf malignancy in giant cell tumor of bone eric staals. The giant cell tumour of bone gct is a locally aggressive intraosseous neoplasm of obscure biological behaviour.
Only five patients were shown to have malignancy in a giant cell tumor at the time of diagnosis. Giant cell reparative granuloma in the temporal bone. The diagnosis of a giant cell tumor is generally made by a pathologist following removal of the mass. Although the tumor was clinically considered a ganglion initially, the microscopic features were identical to those found in classic gct of bone.
Gct may contain woven bone and rarely, neoplastic cartilage nodules which. Malignancy in giant cell tumor is rare giant cell tumors were considered at one time to be malignant lesions and were classified by the term giant cell sarcoma. Pathology materials of giant cell tumors of soft tissue, diagnosed between 2010 and 2015, were collected from the consultation files of one of the. Giantcell tumour of bone with lung metastases case. Giant cell tumour of bone gct is a benign noncancerous tumour which can develop in the bones of the body. Giant cell tumour of the scapula treated by partial. This study investigated the clinical outcome of gctb treated with thorough curettage, phenolization, and cpc. Pdf giant cell tumor of bone an overview researchgate.
The surgical treatment and outcome of pathological. It can arise in any bone but is most common in the legs. Giant cell tumor of bone is one of the common benign aggressive bone tumors 1115. Giant cell tumor of bone gctb is a relatively rare, benign, but locally aggressive osteolytic skeletal neoplasm of young adults. Giant cell tumors typically occur in young adults, and are slightly more common in females. Patient education giant cell tumor center for foot. Giant cell tumors of bone are benign tumors that can be locally aggressive. The younger age of the subjects compared with those who had tumors in. Giant cell tumor gct of bone is a rare, histologically benign but locally aggressive neoplasm of the bone. Giant cell tumour is a benign, but locally aggressive tumour. Giant cell tumor of bone genetic and rare diseases. Most often, the tumors develop at the lower end of the femur thighbone or upper end of the tibia shinbone, close to the knee joint.
The petrous portion of the temporal bone forms a rare location for this tumor. Malignant giant cell tumor of bone mgctb is rare and is currently described as either primary or secondary. Giant cell tumor is a benign but locally aggressive bone neoplasm which uncommonly involves the skull. First recognized in 1818 1, it was not until 1940 that gctb was formally distinguished from other tumors of bone, such as aneurysmal bone cyst, chondroblastoma, and nonossifying fibroma 2. H3f3a gene mutations producing mutant histone protein product h3. In some cases it could be more aggressive and treatment is not always effective. We present you a case of 26yearold man with a large giant cell tumour of the inferior angle of the scapula. The presence of a giant cell tumor gct in the small bones of the hand and foot is rare. Surveillance for lung metastasis from giant cell tumor of bone.
Giant cell tumors gcts are primary bone tumors that involve long bones in 75 to 90% of patients. Most commonly occurring in the metaphyseal region of the long bones, but these tumors can arise in any part of the skeleton. Gctb most often arises in the distal femur and proximal tibia but the end of any. Treatment and recurrence of giant cell tumors of bone a. The local recurrence rate of gct varies in the literature, and the prevalence of local recurrence ranges from 0 to 45% after burring andor chemical adjuvant treatment 48. Malignancy in giant cell tumor is uncommon and occurs in about 2% of all cases. Giant cell tumor is one of the more common benign bone. Gctb accounts for approximately 5% of all primary bone tumors. A rare bone sarcoma characterized by a usually benign spaceoccupying lesion, which is nevertheless locally aggressive and massively damaging to surrounding bone tissue. A deeper understanding of the molecular biology governing the development of gctb has led to the development of denosumab for this disease. The bone sarcoma registry recognizes, in the recent classification, amalignant group and benign epiphysial giant cell tumor group. Not the same tumor as giant cell lesion of the small bones.
Gctb are typically locally aggressive, but metastasize to the lung in 5 % of cases. Giant cell tumor of bone gctb accounts for 5% of primary skeletal tumors. Giant cell tumor of bone gctb first described by cooper and travers in 1818 1. The tumor is composed of giant multinucleated cells osteoclastlike cells, mononuclear macrophages, and mononuclear stromal cells which secrete promyeloid and pro.
Pulmonary metastasis of gctb may be affected by tumor grading and localization as well. Giant cell tumor is a one of the most common primary bone lesions in the distal phalanx. Although giant cell tumours are benign they can be aggressive, which means that they can be fast growing and cause significant damage to the bone and tissue around the bone. The erosion of the bone associated with giant cell tumors is due to pressure on the bone and not due to the invasion of the bone by the tumor. Its relationship to central giant cell granuloma is controversial and some authors claim that these two lesions represent two different stages of the same process 2. Only a few cases have been described in the literature to date. Original article expressions and clinical significance of. However, if malignant degeneration does occur, it is likely to metastasize to the lungs. Giant cell tumor of bone gct is a benign locally aggressive neoplasm composed of mononuclear cells admixed with innumerable osteoclasttype giant cells.
We investigated 26 patients with at least 36 months of. Of the 124 patients with giant cell tumor seen at the mayo clinic during the quarter of a century from. As knowledge concerning their true nature increased, it became evident that some of them were benign lesions and curable by means of surgical removal. In patients with giant cell tumors of bone that have either come back after surgery or cannot be removed with surgery, denosumab can help shrink tumors for a while. These other lesions include aneurysmal bone cysts, simple bone cysts, benign nonossifying fibromas, and fibrous dysplasia. Giant cell reparative granuloma in the temporal bone alvin katz, md, simon hirschl, md a giant cell reparative granuloma gcrg occurred in the temporal bone of a 36yearold woman. Giant cell tumor of bone gctb gctb is a common primary tumor of bone that arises in the epiphysis of a long bone. A giant cell tumor of bone is a type of benign noncancerous tumor that grows at the ends of the bodys long bones. Giant cell tumors gct are benign tumors with potential for aggressive behavior and capacity to metastasize. Their local aggressiveness explained by later nelaton and malignant features showed by virchow 2,3.
It is characterized by the presence of multinucleated giant cells osteoclast like cells. Giant cell tumor of the bone gctob, is a relatively uncommon tumor of the bone. Review article giant cell tumor of bone international journal of. The aim of this study was to analyze the features of lesions such as these in the files of the rizzoli orthopedic institute. Giant cell tumor of the temporal bone a case report. It most commonly affects the epiphysialmetaphyseal region of long bones, but rarely in flat bones. Calcium phosphate cement cpc is a bone void filler used in orthopaedic surgery. Most published articles on primary malignancy in giant cell tumor of bone pmgctb report a small number of cases. Literature documents a close association of secondary sarcomatous transformation in.
Clinically, gct ranges from inactive tumors to aggressive tumors with local extension destroying the cortex and. Giant cell tumor gct of the bone is one of the rare benign, primary, bone tumors and accounts for around 5% of all primary bone tumors. Recurrencerates between 6% and 16% after wide resection and 18% and 56% after extended intralesional curettage. Active untreated lesions are associated with significant focal bone lysis and skeletal complications, including pathologic fracture, pain, limitation of joint motion, nerve compression, and mechanical destabilization of adjacent joints or the axial spine depending on. Symptoms of hear ing loss cleared completely following ra diation therapy. Giant cell tumors of bone gctb are intermediate and locally aggressive bone tumor. He presented with right side severe hearing loss and. The reported incidence of gct in the oriental and asian population is higher than that in the caucasian population and may account for 20% of all skeletal neoplasms.