There is an unusually high prevalence in southern india and china, where gct represents 20% of all primary bone tumors 5,6. Figure 2 tibia showing a lytic expansile lesion with septae consistent with aneurysmal bone cyst. Giant cell tumor of bone following denosumab treatment. It is characterized by the presence of multinucleated giant cells osteoclastlike cells. Gct accounts for 5% of all primary bone tumors and 20% of benign skeletal tumors 57.
Most giant cell tumors occur at the ends of the long bones of the arms and legs, near a joint such as the knee, wrist, hip, or shoulder. Malignancy in giant cell tumor is uncommon and occurs in about 2% of all cases. This pathway is a key signaling pathway of bone remodeling that plays a critical role in differentiation of precursors into multinucleated osteoclasts, and activation of osteoclasts. Abnormal growths found in the bone can be either benign noncancerous or malignant cancerous average fiveyear survival in the united states after being diagnosed with bone and joint cancer is 67%. Calcitonin use in giant cell bone tumors emconsulte. During surgery the tumor is curetted scooped out and then the space is filled with a bone void filler. They are always found at the end of the bone next to the joint.
The diagnosis of a giant cell tumor is generally made by a pathologist following removal of the mass. Giant cell tumor is one of the more common benign bone tumors. Giant cell tumor gct of bone is a benign but aggressive bone tumor originating from mesenchymal cells. The majority of these tumors develop in patients aged. They mostly occur in the long bones found in the arms and legs. Giant cell tumor of bone with secondary aneurysmal bone cyst. Jyunt sel toomer a rare tumor that usually forms in bone, but may also form in cartilage, muscle, fat, blood vessels, or other supportive tissue in the body.
They typically arise from the metaphysis of long bones, extend into the epiphysis adjacent to the joint surface, and have a narrow zone of transition. It is characterized by the presence of multinucleated giant cells osteoclast like cells. 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 accounts for 45% of primary bone tumors and 18. This pathway is a key signaling pathway of bone remodeling that plays a critical role in differentiation of precursors into multinucleated osteoclasts, and activation of osteoclasts leading to bone resorption 32. Due to its efficacy, denosumab is recommended as the first option in inoperable or metastatic gct. A tumor of bone characterized by massive destruction of the end epiphysis of a long bone.
Denosumab is a monoclonal antibody to rank ligand approved for use in giant cell tumour gct of bone. Giant cell tumor of bone gct is difficult to study because of the lack of suitable in vivo models. Giant cell tumor of the bone gctob, is a relatively uncommon tumor of the bone. Giantcell tumor of the bone gctob, is a relatively uncommon tumor of the bone. Several cases of long bone giant cell tumor have been reported in the literature. 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. A giant cell tumor gct of bone is a benign noncancerous bone. Round cell tumors of bone are a divergent group of neoplasms that largely constitute ewing sarcomaprimitive neuroectodermal tumor, small cell osteosarcoma, langerhans cell his. However, if malignant degeneration does occur, it is likely to metastasize to the lungs. The purpose of this study was to evaluate the correlation between the surgical stage and the oncological or functional results of the treatment of giant cell tumor of bone at kyushu university hospital. Giant cell tumor the spine hospital at the neurological institute. Giant cell tumor of bone radiology reference article. Gct mostly affects people between the ages of 20 and 30 years old. The rank pathway is often reported to be involved in the pathogenesis of giant cell tumor of bone gctb.
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. Their local aggressiveness explained by later nelaton and malignant features showed by virchow 2,3. Giant cell tumor gct of bone is a benign but locally aggressive tumor that is characterized by the presence of mononuclear stromal cells and multinucleated giant cells. Giant cell tumor of bone gctb is a relatively rare, benign, but locally aggressive osteolytic skeletal neoplasm of young adults. 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. The majority are treated by aggressive curettage or resection. Malignancy in giant cell tumor is rare 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 of bone primarily affects the young adult patient population. Benign but locally aggressive primary bone neoplasm composed of mononuclear round to spindle cells with numerous evenly dispersed osteoclastlike giant cells. We report the oncologic and functional results and complications associated with curettage, cryosurgery, and cementation in 3 patients with giant cell tumors arising from the tubular bones of the hand. Giant cell tumor of bone gctb first described by cooper and travers in 1818 1. Patient education giant cell tumor center for foot.
Metastasis, with identical morphology to the primary tumor, occurs in a few percent. Giant cell tumor of bone is a benign tumor with an aggressive behavior. It generally occurs in adults between the ages of 20 and 40 years. Its typical subarticular location and high recurrence risk can be associated with significant morbidity.
Although they are benign, gct can grow fast and damage the affected bone and spread to the soft tissue around it. Similarities between giant cell tumor of bone, giant cell tumor of tendon sheath, and pigmented villonodular synovitis concerning ultrastructural cytochemical features of. You may not embed one of our images on your web page without a link back to our site. It usually grows near a joint at the end of the bone. Abstract an electron microscopic examination of tissue from a giant. 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.
Malignancy in giantcell tumor is uncommon and occurs in about 2% of all cases. The multinucleated giant cells appear similar to osteoclasts, which led to the older term osteoclastoma 2. Sarcomatous transformation is rare and typically occurs with a history of recurrences and radiation treatment. Giant cell tumors are usually found in the long bones, most often the distal femur, proximal tibia, and distal radius. Surgery is the best treatment for a giant cell tumor. Giant cell tumors gct are benign tumors with potential for aggressive behavior and capacity to metastasize. Giant cell tumor of bone is very rarely seen in children or in adults older than 65 years of age. A case of recurrent giant cell tumor of bone with malignant. At kyushu university hospital, 55 patients with giant cell tumor of bone were treated between 1963 and 1990. The full text of this article is available in pdf format. 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. 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.
Giant cell tumors are common, comprising 1823% of benign bone neoplasms and 49. Giant cell tumours of the bone make up 45% of all primary tumours which start in the bone. Giant cell tumor or osteoclastoma is a rare tumor, representing only 3 7% of all bone tumors. Anzawa u, hanaoka h, shiraishi t, morioka h, morii t, toyama y. Benign giant cell tumor of bone with pulmonary metastases. Giant cell tumor health encyclopedia university of. 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. We report the case of a patient with a giant cell tumor in the distal ulna.
Giant cell tumor is one of the more common benign bone tumors, occurring in adults ages 20 40 years. If you would like a large, unwatermarked image for your web page or blog, please purchase the appropriate license. The breakdown between sexes has ranged from even to a predilection toward females 51. Giant cell tumor is a one of the most common primary bone lesions in the distal phalanx. Although some studies have reported an equal sex distribution, most show an increased prevalence among females 48.
After performing an instrumental examination, a diagnosis of distal ulna giant cell tumor was. A 17yearold colombian man presented with a painful swelling of the left wrist. Two hundred and fourteen patients with histologically certified gctb have been treated at the authors department from 1980 to 2007. Vascular invasion outside the boundary of the tumor can be seen. An update on recent molecular genetic advances shi wei, md, phd and gene p. Giantcell tumor of bone gctb is a rare tumor typically affecting the bones of skeletally mature young adults, with peak incidence in the third and. Giant cell tumor accounts for 5 to 9 percent of all primary bony tumors. Giant cell tumor of bone a giant cell tumor of bone is a type of benign noncancerous tumor that grows at the ends of the bodys long bones. It most often grows in adults between ages 20 and 40 when skeletal bone growth is done. Tumor surgery tumor education bone tumors types of bone. 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. Giant cell tumours gct are benign noncancerous tumours that develop in the bone. 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. About 70 90% are located at or close the extremities of long bones.
Definition of giant cell tumor of bone medicinenet. In almost all cases, treatment for malignant tumors involves a. Mar 12, 2015 the rank pathway is often reported to be involved in the pathogenesis of giant cell tumor of bone. Local recurrence of giant cell tumor of bone after intralesional treatment with and without adjuvant therapy.
Patients usually present with pain and limited range of motion caused by tumor s proximity to the joint space. A bone tumor is a neoplastic growth of tissue in bone. They almost invariably 9799% occur when the growth plate has closed and are therefore typically seen in early adulthood. Giant cell tumor of bone gct is a benign, locally aggressive bone tumor. 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 tumour of the bone bone cancer research trust. Fresh tumor tissues from 10 patients were obtained and homogenized and the suspension was. Giant cell tumor of bone an overview abstract giant cell tumors gct are benign tumors with potential for aggressive behavior and capacity to metastasize. As osteoclast, giant cell tumors express calcitonin receptors. Giant cell tumor of bone is a rare, fastgrowing noncancer tumor. Review article giant cell tumor of bone international journal of.
Denosumab has also been used preoperatively to downstage tumours with large soft tissue extension to allow for less morbid surgery. Jan 25, 2015 giant cell tumor is a relatively uncommon but painful tumor of bone, which can metastasize to the lungs. Giant cell tumor is one of the more common benign bone. Giant cell tumor of bone is a locally aggressive bone tumor. Giantcell tumor of bone an overview sciencedirect topics. Treatment options for recurrent giant cell tumors of bone. Giant cell tumors of bone, also known as osteoclastomas, are relatively common bone tumors and are usually benign. Giant cell tumor orthopaedicsone articles orthopaedicsone. Giant cell tumor of bone gct is a rare, aggressive noncancerous tumor. Sep 22, 2010 giant cell tumor gct of bone is a locally destructive tumor that occurs predominantly in long bones of postpubertal adolescents and young adults, where it occurs in the epiphysis. Giant cell tumor of bone gpn banff pathology course.
The filler may be bone graft material like allograft bone bank tissue, autograft the patients own bone, bone cement, or a combination of these things. Current status and unanswered questions on the use of. Malignant bone tumors can metastasizeor cause cancer cells to spread throughout the body. Xrays may show the shadow of the mass, and in 1020% of the cases, may demonstrate bone erosion. The role of denosumab for conventional limb gct of bone is. Not the same tumor as giant cell lesion of the small bones. Pdf a shortterm in vivo model for giant cell tumor of bone. The tumor is localized epimetaphyseal end of the bone, mainly in the long bones, especially around the knee in 50%, followed by the axial skeleton, especially the sacrum.
Giant cell tumor of bone was a major falsepositive histopathological subtype of bone tumors, showing high fdg accumulation. Metastases from histologically benign giant cell tumor of bone. Most tumors occur at the bones around the knee 5065% of all cases. 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. This is very unusual, with a reported incidence of 0. Wed like to understand how you use our websites in order to improve them. Giant cell a type of cell formed when individual cells merge.
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