Giant Cell Tumor of the Uterus

Abstract

Giant cell tumors, a well-recognized neoplasm of bone, can rarely be found in the uterus. Such tumors are characterized by a dual population of mononuclear and osteoclast-like giant cells that lack epithelial and specific mesenchymal differentiation. In this study, the clinicopathologic features of 3 giant cell tumors of the uterus were reviewed. Immunohistochemistry for CD68, CD163, h-caldesmon, desmin, SMA, AE1/AE3, CD10, ER, PR, cyclin D1, CD1a, CD34, CD30, S100, myogenin/myoglobin, and Ki-67 was performed in all tumors, along with ultrastructural analysis in one. The patients were 47, 57, and 59 yr and the tumors measured 2.5, 7.5, and 16.0 cm. One neoplasm was confined to the endometrium, whereas the other 2 were myometrial. All 3 tumors showed a nodular growth comprised of mononuclear and osteoclast-like giant cells. The endometrial-confined tumor consisted of histologically benign mononuclear cells, whereas the others exhibited marked atypia. Mitotic activity was up to 5/10 HPF in the benign tumor and up to 22/10 HPF in the malignant. No cytologic atypia or mitoses were observed in the giant cells. CD68 and CD10 were strongly and diffusely expressed in both components of 3 and 2 neoplasms, respectively. Cyclin D1 was focal in the mononuclear cells and focal to diffuse in the giant cells. CD163 was diffuse in the mononuclear cells, but absent to focal in the giant cells. Ultrastructural analysis lacked diagnostic features of epithelial or specific mesenchymal differentiation. Both malignant tumors demonstrated an aggressive behavior. In summary, although rare, giant cell tumor of the uterus should be included in the differential diagnosis of benign or malignant tumors containing osteoclast-like giant cells.

Malignant giant cell tumor of the uterus: a case report

“…12,13 The tumor is considered epithelial if the background cells stain positive to keratin (Cytokeratin AE1/AE3) or epithelial membrane antigen and when they are positive for mesenchymal markers (h-caldesmon, myogenin or DOG1), the tumor is categorized as mesenchymal. 8 In this present case, stain were negative for all markers, except for those with histiocytic differentiation (CD68), being more consistent with the diagnosis of a malignant giant cell tumor. 8,10 In summary, the immunohistochemistry can be heterogeneous, depending on the tumor grade, the malignant potential, and whether neoplasm contains two or more histological components.…”

“…8 In this present case, stain were negative for all markers, except for those with histiocytic differentiation (CD68), being more consistent with the diagnosis of a malignant giant cell tumor. 8,10 In summary, the immunohistochemistry can be heterogeneous, depending on the tumor grade, the malignant potential, and whether neoplasm contains two or more histological components. CD68 usually stains the mononuclear and osteoclastlike cells, CD10 usually shows strong membranous staining for both cell types and cytoplasmic staining in the mononuclear cells, and Cycline D1 is positive in the nuclei of the osteoclast-like giant cells.…”

“…3 Important differential diagnoses include osteosarcoma, fibrosarcoma, brown malignant fibrous histiocytoma in hyperparathyroidism, giant cells granulomas and metastatic carcinomas 14 . GCT of the uterus should also be included as a differential diagnosis of benign or malignant tumors containing giant OLGCs 8,11 .In the female genital tract, OLGCs have most commonly been reported as a component of uterine leiomyosarcomas, but they have also been described in an endometrial stromal tumor, uterine pleomorphic rhabdomyosarcoma, an endometrial adenosquamous carcinoma, a variety of ovarian tumors, and a sarcomatoid carcinoma of the cervix. 17,18 Given the rarity of this condition, there are still no consensus regarding the most appropriate treatment, but for localized tumors, when feasible, surgical approach is recommended, followed or not by adjuvant radiation.…”

“…More studies are warranted to shed light on the pathogenesis of GCT of soft tissue. 8,14 The differential diagnosis is challenging, as giant cells can be found in carcinomas and poorly differentiated sarcomas. For this reason, a qualified team is imperative in order to obtain better patient outcomes.…”

Fatal bronchopneumonia caused by skunk adenovirus 1 in an African pygmy hedgehog

“…The tissue was washed in sodium cacodylate buffer, fixed in modified Karnovsky fixative, processed (Lynx tissue processor, Electron Microscopy Science, Hatfield, PA), embedded in epoxy resin, cut into thin sections, stained, and examined (Morgagni TEM, FEI, Hillsboro, OR) as described previously. 4 Icosahedral viral particles with capsids were noted in necrotic nuclear and cellular debris (Fig. 1C).…”