What is giant cell tumor

He is otherwise healthy and denies trauma. A chest radiograph reveals a lung nodule. Which of the following tumors most likely to metastasize to lung? Which figure shows the most common sites of giant cell tumor distribution in bone? Giant Cell Tumor. Ben Sharareh. Patrick O'Donnell. Giant Cell Tumors are benign, aggressive tumors typically found in the epiphysis of long bones, most commonly at the distal femur and proximal tibia.

Patients typically present between ages 30 and 50 with insidious onset of pain of the involved extremity with activity, at night, or at rest. Diagnosis is made with a biopsy showing mononuclear stromal cells that resemble interstitial fibroblasts with numerous giant cells dispersed throughout. Treatment is generally curettage, adjuvant treatment, and reconstruction as necessary depending on the location of the lesion. Anatomic location. Associated conditions. Physical exam. Bone scan. Study Findings.

Metastatic Cancer Research. Intramural Research. Extramural Research. Cancer Research Workforce. Partners in Cancer Research. What Are Cancer Research Studies. Research Studies. Get Involved. Cancer Biology Research. Cancer Genomics Research. Research on Causes of Cancer. Cancer Prevention Research. Cancer Treatment Research. Cancer Health Disparities. Childhood Cancers Research. Global Cancer Research. Cancer Research Infrastructure. Clinical Trials.

Frederick National Laboratory for Cancer Research. Bioinformatics, Big Data, and Cancer. Annual Report to the Nation. Research Advances by Cancer Type. Stories of Discovery. Milestones in Cancer Research and Discovery.

Biomedical Citizen Science. Director's Message. Budget Proposal. Stories of Cancer Research. Driving Discovery. Highlighted Scientific Opportunities. Research Grants. Related Specialties Spine Disorders. Symptoms One common symptom of a spinal giant cell tumor is pain at the tumor site. Diagnosis Giant cell tumors can be identified on several types of imaging scans: X-ray also known as plain films : test that uses invisible electromagnetic energy beams X-rays to produce images of bones.

Soft-tissue structures such as the spinal cord, spinal nerves, the disc, and ligaments are usually not seen on X-rays, nor on most tumors, vascular malformations, or cysts.

X-rays provide an overall assessment of the bone anatomy as well as the curvature and alignment of the vertebral column.

Spinal dislocation or slippage also known as spondylolisthesis , kyphosis, scoliosis, as well as local and overall spine balance can be assessed with X-rays. Specific bony abnormalities such as bone spurs, disc space narrowing, vertebral body fracture, collapse, or erosion can also be identified on plain film X-rays.

Magnetic resonance MR imaging scan : uses radio waves and a magnet to produce images of organs and tissues Computed tomography CT scan : uses X-rays and a computer to produce cross-sectional images of bones and other structures A CT-guided needle biopsy may help confirm the diagnosis, which helps in treatment planning. Risk Factors The causes of giant cell tumors are not well understood. Treatments Though GCTs are benign tumors that do not usually spread, they are sometimes described as locally aggressive.

Depending on the tumor location, surgical options include: Anterior cervical corpectomy Cervical laminectomy Thoracic corpectomy Thoracic laminectomy Lumbar laminectomy Lumbar corpectomy Sacrectomy Microsurgical tumor removal Stereotactic radiosurgery Spinal fusion and stabilization with metallic implants are often performed following complete tumor removal. Thoracic Laminectomy. Cervical Laminectomy. Hence, this entity has been called benign metastasizing giant cell tumor 10, It is important to realize that features may be difficult to interpret histologically with a relatively wide histological differential diagnosis e.

They typically occur as single lesions. Although any bone can be affected, the most common sites are 1,2 :. There are four characteristic radiographic features when a giant cell tumor is located in a long bone:. On bone scintigraphy, most giant cell tumors demonstrate increased uptake on delayed images, especially around the periphery, with a central photopenic region doughnut sign.

Increased blood pool activity is also seen, and can be seen in adjacent bones due to generalized regional hyperemia contiguous bone activity. If performed, usually in the setting of preoperative embolization, angiography usually demonstrates a hypervascular tumor two-thirds of cases with the rest being hypovascular or avascular.

Classically, treatment is with curettage and packing with bone chips or polymethylmethacrylate PMMA. Newer intraoperative adjuncts such as thermocoagulation, cryotherapy, or chemical treatment of the resection margins have lowered the recurrence rate to 2. Early work on monoclonal antibodies e. Wide local excision is associated with a lower recurrence rate but has greater morbidity.

The differential diagnosis for bone tumors is dependent on the age of the patient, with a very different set of differentials for the pediatric patient. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Updating… Please wait. Unable to process the form. Check for errors and try again.

Thank you for updating your details. Log In. Sign Up. Become a Gold Supporter and see no ads. Log in Sign up.