Giant cell tumor of bone

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For patient information, click here Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Osteoclastoma; giant cell myeloma; giant cell tumor

Overview

Historical Perspective

Pathophysiology

Giant cell tumor of bone occurs commonly in the distal femur, the proximal tibia, the distal radius and the sacrum. Giant cell tumors (GCT) usually prefers the epiphyses of long bones.[1]

Causes

Epidemiology and Demographics

Giant cell tumor of the bone accounts for 4-5% of primary bone tumors and 18.2% of benign bone tumors [2].

Age

  • Giant cell tumor is more common in young adults between 20 and 40 years of age.

Gender

  • Giant cell tumor of bone is more common in females with the rate of growth enhanced in pregnancy.

Risk Factors

Differentiating Giant cell tumor of bone from other Diseases

A number of tumors have giant cells, but are not true benign giant cell tumors. These include

Natural History, Complications and Prognosis

Complications

Recurrence rates are higher when GCT arises at a surgical inaccessible location (e.g. spine and sacrum).

Diagnosis

Staging

History and Symptoms

  • Patients usually present with pain and limited range of motion caused by tumor's proximity to the joint space.
  • There may be swelling as well, if the tumor has been growing for a long time.
  • Some patients may be asymptomatic until they develop a pathologic fracture at the site of the tumor.

Physical Examination

Laboratory Findings

X Ray

On x-ray, giant cell tumors (GCTs) have a metaepiphyseal location and grow to the articular surface of the involved bone [3]. They are distinguishable from other bony tumors in that GCTs usually have a non-sclerotic and sharply defined border. Because giant cell tumors are known to metastasize, when the diagnosis of giant cell tumor is suspected, a chest x-ray or CT may be needed.

(Images courtesy of RadsWiki)

  • Giant cell tumor: Distal part of the femur
    Giant cell tumor: Distal part of the femur
  • Giant cell tumor: Distal part of the femur
    Giant cell tumor: Distal part of the femur

CT

MRI

Treatment

Medical Therapy

Surgery

References

  1. ↑ Shrivastava, Sandeep; Nawghare, Shishir P; Kolwadkar, Yogesh; Singh, Pradeep (2008). "Giant cell tumour in the diaphysis of radius – a report". Cases Journal. 1 (1): 106. doi:10.1186/1757-1626-1-106. ISSN 1757-1626.
  2. ↑ Gamberi G, Serra M, Ragazzini P, Magagnoli G, Pazzaglia L, Ponticelli F, Ferrari C, Zanasi M, Bertoni F, Picci P, Benassi MS (2003). "Identification of markers of possible prognostic value in 57 giant cell tumors of bone". Oncology Reports. 10 (2): 351–6. PMID 12579271. Retrieved 2012-01-18.
  3. ↑ Murphey MD, Nomikos GC, Flemming DJ, Gannon FH, Temple HT, Kransdorf MJ (2001). "From the archives of AFIP. Imaging of giant cell tumor and giant cell reparative granuloma of bone: radiologic-pathologic correlation". Radiographics : a Review Publication of the Radiological Society of North America, Inc. 21 (5): 1283–309. PMID 11553835. Retrieved 2012-01-18.


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