Giant cell tumors of the clivus: Case report and literature review

Abstract

Background:Clival giant cell tumors (GCTs) are extremely rare with only eight cases reported to date, and malignant transformation is quite rare. Herein, we report a case of an uncontrolled clival GCT, which was transformed malignant, and review the literature.Case Description:A 25-year-old man experienced double vision for 1 month. Computed tomography and magnetic resonance imaging revealed a clival tumor. The endonasal endoscopic transsphenoidal approach (EEA) was used, and partial resection was performed because of massive bleeding. Histological examination showed a GCT. After radiation therapy, the tumor recurred; the EEA and the anterior transpetrosal approaches were used to perform second and third operations, respectively. The MIB-1 index increased from 4.2% to 26.3%.Conclusions:GCTs are difficult to treat because of their location, vascularity, and the potential for malignant transformation.

A rare tumor of clivus masquerading as pituitary adenoma

“…[ 5 ] Among the cases reported in the literature, two patients succumbed to metastatic GCT of the clivus. [ 6 7 ] In the case reports by Scotto di Carlo et al ., one patient had an aggressive tumor which recurred after 1 month of the first surgery.…”

Unresectable Clival Giant Cell Tumor, Tumor Control With Denosumab After Relapse: A Case Report and Systematic Review of the Literature

“…13 In case 15, the tumor gradually regrew from 2 months' postradiation, with an increased pathologic MIB-1 index up to 26.3% that was considered a malignant transformation by the authors. 19 Overall, 6 patients received denosumab treatment for a mean therapy time ranging from 5 months to 5 years. The doses consisted of monthly administrations with additional doses on day 8 and 15 only in the first month of therapy.…”

“…The tumor showed a moderate to high vascularity in the majority of cases and in 3 cases a massive bleeding from the ICA was observed as a consequence of tumor resection. 14 , 19 , 27 Histologically, tumor was described as composed from numerous multinucleated osteoclast-like giant cells scattered throughout the mass and ovoid or spindle mononuclear stromal cells with variable cellularity, while rare necrosis and insignificant cellular atypia. Osteoclast-like giant cells showed a variable number of nuclei (range: 10 to 40) and they were bigger in 1 case, with 50 to 70 nuclei.…”

“… 13 In case 15, the tumor gradually regrew from 2 months’ postradiation, with an increased pathologic MIB-1 index up to 26.3% that was considered a malignant transformation by the authors. 19 …”

Giant cell tumor of the sella as a rare cause of hyperprolactinemia

“…The skull base and sellar area is an uncommon location for giant cell tumors (GCTs), locally aggressive osteolytic neoplasms [2]. Although histologically benign lesions, they present local recurrences and sporadically demonstrate metastatic potential.…”