Treatment options for recurrent giant cell tumors of bone. The majority of these tumors develop in patients aged. Local recurrence of giant cell tumor of bone after intralesional treatment with and without adjuvant therapy. Softtissue recurrence of giantcell tumor of bone after irradiation and excision. Giant cell tumor gct of bone is a benign but aggressive bone tumor originating from mesenchymal cells. Giant cell tumor of bone, sometimes referred to as conventional giant cell tumor, is a benign locally aggressive neoplasm which accounts for five percent of primary osseous neoplasms. A rare bone sarcoma characterized by a usually benign spaceoccupying lesion, which is nevertheless locally aggressive and massively damaging to surrounding bone tissue. Abstract giant cell tumor gct of bone is a locally aggressive benign neoplasm that is associated with a large biological spectrum ranging from latent benign to highly recurrent and occasionally metastatic malignant bone tumor. It usually grows near a joint at the end of the bone.
While a giant cell tumor can occur in any bone, it is most commonly located in the metaphysis or at the end epiphysis of the thigh bone femur or shin bone tibia. Malignancy in giant cell tumor is rare 50%, followed by the axial skeleton, especially the sacrum. 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. The us food and drug administration fda today expanded the approved use of denosumab xgeva, amgen to include the treatment of adults and some adolescents with giant cell tumor of the bone. Similarities between giant cell tumor of bone, giant cell tumor of tendon sheath, and pigmented villonodular synovitis concerning ultrastructural cytochemical features of. Giant cell tumour of the bone bone cancer research trust. It causes pain, restricts movement, and is usually cancerous. The giant cell tumour of bone gct is a locally aggressive intraosseous neoplasm of obscure biological behaviour. Pdf icon sarcoma uk factsheet giant cell sarcoma of the bone. Giant cell tumor is one of the more common benign bone tumors, occurring in adults ages 20 40 years. Giant cell tumor gct of bone is one of the commonest benign bone tumors encountered by an orthopedic surgeon. Imaging studies are important for tumor staging and radiographic grading.
Two cases of sarcoma arising in giant cell tumor of bone. Clinical and radiological data of 115 patients with giant cell tumor of bone was analyzed. Anchan c 2008 giant cell tumor of bone with secondary aneurysmal bone cyst. List of giant cell tumor of bone medications 2 compared. Although the recurrence rate of giant cell tumors of bone gctb is relatively high exact data on treatment options for the recurrent cases is lacking. Pdf giant cell tumor gct of bone is generally a benign tumor composed of mononuclear stromal cells and characteristic multinucleated. The petrous portion of the temporal bone forms a rare location for this tumor. Giant cell tumor of bone gpn banff pathology course. Giant cell tumor of bone gctb is a relatively rare, benign but locally aggressive osteolytic skeletal neoplasm of young adults. The aim of this study was to compare cgcg of the jaws and gct of long bones from clinicopathology, cytometry and immunohistochemistry aspects. Typically, these clinically active but slowgrowing tumors are confined to bone, with relatively welldefined radiographic.
Anzawa u, hanaoka h, shiraishi t, morioka h, morii t, toyama y. Only five patients were shown to have malignancy in a giant cell tumor at the time of diagnosis. Twentyfive of these 31 had previously been irradiated. Giant cell tumor of bone gct is a rare, aggressive noncancerous tumor. Malignancy in giantcell tumor is uncommon and occurs in about 2% of all cases.
The tumor is generally benign and characterized histologically by multinucleated giant cells with a background of mononuclear stromal cells. The axial skeletonprimarily the sacrumis a secondary site of involvement. Denosumab, an inhibitor of the rank ligand involved in bone resorption in gct, is increasingly used in treatment of recurrent or unresectable giant. Giant cell tumor of bone gctb accounts for 5% of primary skeletal tumors. Giant cell tumor of bone with pulmonary and lymph node metastases. Initially, described by cooper and travers in 1818 as an aggressive and destructive lesion of long bones, then virchow first described the recurrence and possible degeneration into a malignant gct. Definition of giant cell tumor of bone medicinenet. However, if malignant degeneration does occur, it is likely to metastasize to the lungs.
Get a printable copy pdf file of the complete article 4. Giant cell tumor of bone is very rarely seen in children or in adults older than 65 years of age. The possible surgical procedures range from repeated intralesional curettage to wide resection. The following list of medications are in some way related to, or used in the treatment of this condition. 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. Giant cell tumor orthopaedicsone articles orthopaedicsone. References indian journal of radiology and imaging 2003. Literature documents a close association of secondary sarcomatous transformation in. The authors present data that purports a predictive value to vegf expression in giant cell tumor of bone supported by a correlation between the levels of vegf expression and. A giant cell tumor of bone is a type of benign noncancerous tumor that typically occurs in young adults between the ages of 20 and 40. Giant cell tumours of the bone make up 45% of all primary tumours which start in the bone. This is very unusual, with a reported incidence of 0. He presented with right side severe hearing loss and. Giant cell tumor of bone gct is a benign locally aggressive neoplasm composed of mononuclear cells.
Not the same tumor as giant cell lesion of the small bones. Several cases of long bone giant cell tumor have been reported in the literature. Musculoskeletal imaging 197 giant cell tumor of bone. Their local aggressiveness explained by later nelaton and malignant features showed by virchow 2,3. Giant cell tumor of the bones of the hand and foot biscaglia 2000. Giant cell tumor of bone an overview abstract giant cell tumors gct are benign tumors with potential for aggressive behavior and capacity to metastasize. Introduction giant cell tumor gct of bone was described by cooper and travers 1 in 1818. The breakdown between sexes has ranged from even to a predilection toward females 51. Giant cell tumor gct of bone is a generally benign, but often locally aggressive, neoplasm of bone, with a propensity for recurrence.
Giant cell tumor health encyclopedia university of. Although well defined in clinical, radiological and histological terms, detailed information on its biological development is still relatively incomplete. Giantcell tumor of the bone gctob, is a relatively uncommon tumor of the bone. A 17yearold colombian man presented with a painful swelling of the left wrist. Giant cell tumor of bone is a benign tumor with an aggressive behavior. The tumor is composed of giant multinucleated cells osteoclastlike cells, mononuclear macrophages, and mononuclear stromal cells which secrete promyeloid and pro. Giant cell tumor is one of the more common benign bone. Its typical subarticular location and high recurrence risk can be associated with significant morbidity. Patients usually present with pain and limited range of motion caused by tumors proximity to the joint space. A tumor of bone characterized by massive destruction of the end epiphysis of a long bone. Case report giant cell tumor of the maxilla in an 8 year. Pdf giant cell tumors gct are benign tumors with potential for aggressive behavior and capacity to metastasize. The site most commonly struck by this tumor is the knee the far end of the femur and the near end of the tibia. Zheng mh, fan y, panicker a, et al detection of mrnas for urokinasetype plasminogen activator, its receptor, and type 1 inhibitor in giant cell tumors of bone with in situ hybridization.
Giant cell tumor of bone with secondary aneurysmal bone cyst. Figure 2 tibia showing a lytic expansile lesion with septae consistent with aneurysmal bone cyst. The rank pathway is often reported to be involved in. Central giant cell granuloma cgcg of the jaws and giant cell tumor gct of bone share a number of similarities and dissimilarities in respect of their histopathological, cytometric and immunohistochemical features. 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. The location of a giant cell tumor is often in the knee, but can also. Review article giant cell tumor of bone international journal of. Pdf giant cell tumor of bone an overview researchgate. It most often grows in adults between ages 20 and 40 when skeletal bone growth is done. 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.
Cooper in 1818 first described giant cell tumors gct of the bone 1. It accounts for 410% of all bone tumors and typically affects the metaepiphyseal region of long bones of young. Giantcell tumor of bone is a rare, locally aggressive tumor that typically occurs in the bones of skeletally mature young adults in. Giant cell tumor of bone gctb first described by cooper and travers in 1818 1. Giant cell tumor of soft tissue is genetically distinct from its bone. Pathology materials of giant cell tumors of soft tissue, diagnosed between 2010 and 2015, were collected from the consultation files of one of the. Note, giant cell tumor of bone is a locally aggressive primary bone neoplasm. Two hundred and fourteen patients with histologically certified gctb have been treated at the authors department from 1980 to 2007. Most often, the tumors occur close to the knee jointat the lower end of the thighbone femur or the upper end of the shinbone tibia.
Although it is considered to be a benign lesion, there are still incidences of pulmonary metastasis. Genetically, 80% of individuals with giant cell tumor of bone exhibit the cytogenetic abnormality of teleomeric associations tas, whereas half of the cells in the tumor show the tas abnormality 1,31. Patients with local recurrence are more likely to develop pulmonary. Benign but locally aggressive primary bone neoplasm composed of mononuclear round to spindle cells with numerous evenly dispersed osteoclastlike giant cells. The majority are treated by aggressive curettage or resection. It is characterized by the presence of multinucleated giant cells osteoclastlike cells. After performing an instrumental examination, a diagnosis of distal ulna giant cell tumor was. Giant cell tumor of bone genetic and rare diseases. Pulmonary metastasis of gctb may be affected by tumor grading and localization as well as the age, gender and overall health status of the patient. It generally occurs in adults between the ages of 20 and 40 years. Most patients present with pain, swelling, joint effusion, and disability in the third and fourth decades of life. 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 tumors gcts of the bone account for 5% of all primary bone tumors. However, for unknown reasons, this tumour occurs 2 to 3 times more often in southern india and china where giant cell tumours of the bone make up a much larger 20% of all primary bone tumour cases1,3 some reports show a higher number of giant cell tumour of the bone cases in female patients than.
The site most commonly involved by this tumor is the knee, both the far end of the femur and the near end of the tibia. Secondary tumors of bone mechanism of transport paravertebral venous plexuses retrograde access of tumor cells to bone bypass of portocaval venous drainage primary neoplasms of bone definition. We report the case of a patient with a giant cell tumor in the distal ulna. Of 327 patients who had a giantcell tumor of bone and were seen at the istituto rizzoli, 293 were t. Vascular invasion outside the boundary of the tumor can be seen.
The patients were 30 years old in average and the most common site. 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. Tumor surgery tumor education bone tumors types of. Giant cell tumors most commonly occur in the distal femur, proximal tibia and distal radius. Pulmonary metastasis of giant cell tumor of bones world. Giant cell tumor of the temporal bone sciencedirect. Giant cell tumor of bone list of high impact articles. Giant cell tumor of bone is a rare, fastgrowing noncancer tumor. Central giant cell granuloma of the jaws and giant cell.
Sarcomatous transformation is rare and typically occurs with a history of recurrences and radiation treatment. Giant cell tumor of the temporal bone a case report. Giant cell tumor of bone gctb is a relatively rare, benign, but locally aggressive osteolytic skeletal neoplasm of young adults. Giant cell tumor is a benign but locally aggressive bone neoplasm which uncommonly involves the skull.
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