QUASIMALIGNANT MALIGNANT BONE TUMOR

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QUASI-MALIGNANT MALIGNANT BONE TUMOR

• GIANT CELL TUMOR

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GIANT CELL TUMOR

• General Considerations
• A.k.a. Osteoclastoma, GCT
• Derived from connective skeletal tissue
• Quasimalignant
• Difficult to predict the future behavior
  histologically or radiographically

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GIANT CELL TUMOR

• Signs and Symptoms
• M/C age 20-40 FgtM
• Intermediate dull ache
• Sometimes a palpable, tender mass
• Symptoms in contiguous joint often develop
• Pathologic fx. may develop

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GIANT CELL TUMOR

• Laboratory Considerations
• When GCT is considered the following studies
  should be obtained to R/O a brown tumor of HPT
• Serum calcium
• Serum phosphorus
• Alkaline phosphatase

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GIANT CELL TUMOR

• Skeletal Locations
• M/C location distal femur and proximal tibia.
• Distal radius, almost all tubular bones
• Sacrum is m/c spinal site
• M/C benign tumor of the sacrum

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GIANT CELL TUMOR

• Radiographic and Imaging Features
• Metaphysis and usually extends to the bone end
• Typically eccentric
• Classic appearance Roundish, moderate-sized,
  expansile lesion radiolucent lesion extending to
  the subarticular surface
• Light trabeculation often occurs

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GIANT CELL TUMOR

• Radiographic and Imaging Features
• Margin is fairly well-defined neither a
  sclerotic margin or wide transition zone
• Cortex is expanded and thin
• Typically no periosteal response
• Cortex may be destroyed with soft tissue invasion

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GIANT CELL TUMOR

• Differential Diagnosis
• Metastatic disease
• Plasmacytoma
• Fibrosarcoma
• Chondrosarcoma

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GIANT CELL TUMOR

• Treatment and Prognosis
• Resection
• Scrape and pack with bone chips
• Prognosis is good with benign but poor with
  malignant
• Recurrence is common