We estimated the 2017 incidence of gct in china using a direct registrybased approach with available populationbased data. 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 bone with pulmonary and lymph node metastases. Anzawa u, hanaoka h, shiraishi t, morioka h, morii t, toyama y. Giant cell tumor of bone gctb is an aggressive osteolytic tumor that. Quantifying the incidence of giant cell tumor gct of bone is challenging because it is a rare, histologically benign bone tumor for which populationlevel statistics are unavailable in most countries. A 17yearold colombian man presented with a painful swelling of the left wrist. Giant cell tumour of bone gctb is a rare osteolytic tumour that is responsible for approximately 6 % of all primary bone tumours. Mar 12, 2015 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. Giant cell tumor of bone list of high impact articles. Giant cell tumor of bone is a benign tumor with an aggressive behavior.
Surgery is the primary mode of treatment, but gct has a tendency to recur locally. 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. You were so generous to give up your time on a weekend to operate on my femur. It generally occurs in adults between the ages of 20 and 40 years. Several cases of long bone giant cell tumor have been reported in the literature. Giant cell tumor of bone gct is a benign, locally aggressive bone tumor. Giant cell tumor of bone gctb accounts for 5% of primary skeletal tumors.
It usually grows near a joint at the end of the bone. 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. Giantcell tumor of bone an overview sciencedirect topics. A case of recurrent giant cell tumor of bone with malignant. Giant cell tumor of bone gctb is a primary bone tumor composed of two types of cells. A giant cell tumor gct of bone is a benign noncancerous bone. Giant cell tumor of bone primarily affects the young adult patient population. Giant cell tumor of bone, curettage, cementation, cauterization. Giant cell tumor of bone gctb is a relatively rare, benign, but locally aggressive osteolytic skeletal neoplasm of young adults. Sarcomatous transformation is rare and typically occurs with a history of recurrences and radiation treatment.
Introduction giant cell tumor gct of bone is a relatively common, locally aggressive benign neoplasm that is associated with a large biological spectrum ranging from latent benign to highly. They almost invariably 9799% occur when the growth plate has closed and are therefore typically seen in early adulthood. Pdf giant cell tumour of bone gctb is an intermediate locally aggressive primary bone tumour. Malignant transformation occurs in a small percentage of cases, usually following radiation therapy. Giant cell tumours of the bone make up 45% of all primary tumours which start in the bone. Giant cell tumor gct of bone is a benign but aggressive bone tumor originating from mesenchymal cells. Giant cell tumor is one of the more common benign bone tumors, occurring in adults ages 20 40 years. Local recurrence of giant cell tumor of bone after intralesional treatment with and without adjuvant therapy.
Giant cell tumor of the bone gctob, is a relatively uncommon tumor of the bone. Less than 5% of patients with benign giant cell tumor develop metastases, usually to lungs. 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. When the morbidity of surgery would be excessive, radiation. Definition of giant cell tumor of bone medicinenet. Giant cell tumor of bone gpn banff pathology course. The fever might be attributable to the tumor releasing inflammatory cytokines. Not only pain and swelling but also continuous pyrexia may suggest the diagnosis of a secondary. It is characterized by the presence of multinucleated giant cells osteoclastlike cells. Giant cell tumor orthopaedicsone articles orthopaedicsone. Giant cell tumors of bone are uncommon lesions in general orthopedic practice.
Denosumab, an inhibitor of the rank ligand involved in bone resorption in gct, is increasingly used in treatment of recurrent or unresectable giant. You may not embed one of our images on your web page without a link back to our site. It is defined as a highgrade sarcoma originating in a giant cell tumor gct and seems to behave less aggressively than its secondary counterpart does. 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. As a result of reading this article, physicians should be able to. Mononuclear stromal cells are the physiologically active and diagnostic cell type. Although well defined in clinical, radiological and histological terms, detailed information on its biological development is still relatively incomplete.
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. Giant cell tumors are common, comprising 1823% of benign bone neoplasms and 49. Malignancy in giant cell tumor is uncommon and occurs in about 2% of all cases. Recognize the biology that drives giant cell tumor of bone. However, in large series of patients, such as those of the mayo clinic dahlin, 1981 they constitute 5% of the total number of bone tumors and if grouped with the benign lesions, constitute 20%. 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. Pdf giant cell tumour of bone in the denosumab era researchgate. 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. This is very unusual, with a reported incidence of 0.
Identify atrisk populations for giant cell tumor of bone. Historically, gctb have been treated primarily with surgery. Metastasis, with identical morphology to the primary tumor, occurs in a few percent. Giant cell tumor is one of the more common benign bone tumors. Its typical subarticular location and high recurrence risk can be associated with significant morbidity. Treatment options for recurrent giant cell tumors of bone. Bortezomib inhibits giant cell tumor of bone through induction of. Giant cell tumors gct are benign tumors with potential for aggressive behavior and capacity to metastasize. It usually develops in long bones but can occur in unusual locations. Tumor surgery tumor education bone tumors types of bone. This report presents the case of a 39yearold female with pain in her left shoulder for one month. 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. Giant cell tumor of bone gctb comprises up to 20 % of benign bone tumors in the us.
Soft tissue giant cell tumor of low malignant potential of the neck. 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. We report the case of a patient with a giant cell tumor in the distal ulna. The rank pathway is often reported to be involved in the pathogenesis of giant cell tumor. Pdf a shortterm in vivo model for giant cell tumor of bone. Giantcell tumor of bone is a rare, locally aggressive tumor that typically occurs in the bones of skeletally mature young adults in. However, if malignant degeneration does occur, it is likely to metastasize to the lungs. A shortterm in vivo model for giant cell tumor of bone. 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. Gctb are typically locally aggressive, but metastasize to the lung in 5 % of cases. This benign mesenchymal tumor has characteristic multinuclear giant cells. Radiation therapy for giant cell tumors of bone request pdf.
The giant cell tumour of bone gct is a locally aggressive intraosseous neoplasm of obscure biological behaviour. Two cases of sarcoma arising in giant cell tumor of bone. Giant cell tumour of bone in the denosumab era sciencedirect. Two hundred and fourteen patients with histologically certified gctb have been treated at the authors department from 1980 to 2007. Secondary malignancy in giant cell tumor of bone arising after treatment of a benign giant cell tumor has a poor prognosis akin to other high grade sarcomas and much worse than primary malignancy in giant cell tumor of bone cancer 2003. Giant cell tumor is a relatively uncommon but painful tumor of bone, which can metastasize to the lungs. Giant cell tumor of bone gct is a rare, aggressive noncancerous tumor. 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. 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 is very rarely seen in children or in adults older than 65 years of age. The majority are treated by aggressive curettage or resection.
It most frequently occurs in young adults between 20 and 40 years of age with a slight female predominance 25. The possible surgical procedures range from repeated intralesional curettage to wide resection. Epidemiology of benign giant cell tumor of bone in the. Giant cell tumour gct of bone is classified by the world health organisation who as a benign but locally aggressive tumour that usually involves the end of a long bone. Reported annual incidence ranges between 1 and 6 per 10 million persons 1, 2 to approximately 1 per million in the us, western australia, japan and sweden. A tumor of bone characterized by massive destruction of the end epiphysis of a long bone. Giant cell tumor health encyclopedia university of. Giant cell tumor gct of bone is one of the commonest benign bone tumors encountered by an orthopedic surgeon. Bone tumors develop when cells within a bone divide uncontrollably, forming a lump or mass of abnormal tissue. Giant cell tumor of bone accounts for 45% of primary bone tumors and 18. Giant cell tumor of bone is a locally aggressive bone tumor. Giant cell tumor the spine hospital at the neurological institute. Giant cell a type of cell formed when individual cells merge. Giant cell tumor gct of bone is one type of giant cell rich lesion of bone.
Although it is considered to be a benign lesion, there are still incidences of pulmonary metastasis. Vascular invasion outside the boundary of the tumor can be seen. Giant cell tumor gct of bone is a generally benign, but often locally aggressive, neoplasm of bone, with a propensity for recurrence. If you would like a large, unwatermarked image for your web page or blog, please purchase the appropriate license. Giant cell tumor of bone is a rare, fastgrowing noncancer tumor. It most often grows in adults between ages 20 and 40 when skeletal bone growth is done. Giant cell tumor of bone gctb is a rare, benign, highly osteolytic. Similarities between giant cell tumor of bone, giant cell tumor of tendon sheath, and pigmented villonodular synovitis concerning ultrastructural cytochemical features of multinucleated giant cells and mononuclear stromal cells. 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. Giant cell tumor of bone almost invariably occur when the growth plate has closed and are therefore typically observed in early adulthood, with 80% of cases reported between the ages of 20 and 50, with a peak incidence between 20 and 30. Giant cell tumour of bone gctb is a locally aggressive rank ligand.
Secondary malignant giant cell tumor of bone due to malignant. The rank pathway is often reported to be involved in the pathogenesis of giant cell tumor of bone. Sep 03, 2019 present da, bertoni f, springfield d, braylan r, enneking wf. Giant cell tumor gct of bone is generally a benign tumor composed of mononuclear stromal cells and characteristic multinucleated giant cells that exhibit osteoclastic activity. Rare malignant transformation of benign lesion may be observed with or without use of adjuvant radiotherapy. Giant cell tumor of bone radiology reference article. The natural history of gct is progressive bone destruction leading to joint deformity and disability. Pdf pulmonary metastasis of giant cell tumor of bones.
Softtissue recurrence of giant cell tumor of bone after irradiation and excision. Wittig, i am writing at a loss to find adequate words to thank you for all that you have done for me. The absence of clinical, radiographic, or pathologic features that are predictive of tumor behavior and patient outcome has resulted in recent attention to the pathobiology of giant cell tumor of bone. Most gcts are located in the epiphyseal regions of long bones.
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