Giant-Cell Tumors of the Temporal Bone: Management Strategies

Abstract

Objective: To discuss the current management options for giant-cell tumors (GCTs) involving the temporal bone and present two case reports and a review of the literature. Method: In a tertiary-care academic medical center, two patients with GCTs of the temporal bone were evaluated and managed. The patients underwent gross total resection and curettage of GCTs involving the temporal bone. Afterward, both patients were evaluated for postoperative complications as well as for recurrence. Results: Two patients underwent operative excision using curettage. Clinical and radiographic studies demonstrated no evidence of recurrence with 3 years of follow-up in one patient and 10 years of follow-up in the second patient. Conclusion: Based on these results, we concluded that gross total removal and curettage of GCTs in the temporal bone is a viable treatment option. This finding is contrary to previous studies. KEYWORDS:Temporal bone, giant-cell tumors, skull base Giant-cell tumors (GCTs) are rare lesions of the temporal bone that are most commonly found at the epiphysis of long bones.1 Two percent of these lesions present in the head and neck, with the most common sites being the sphenoid, ethmoid, and temporal bones.2 The senior author has treated two patients with GCTs involving the temporal bone with long-term follow-up. This article describes their presentation, diagnostic workup, treatment, and follow-up, as well as provides a review of the literature. CASE 1A 42-year-old man presented to an outside physician with a long history of reduced hearing in the right ear. The patient reported progressive deterioration over the last 3 years, and, in the year before presentation, he noted complete loss of useful hearing in his right ear. The patient denied headache, otalgia, facial pain, trismus, facial weakness, and paresthesias. He denied vision changes, difficulty with swallowing and speech, and changes in voice.

Giant Cell Tumors of the Skull Base: Case Series and Current Concepts

“…Around 1-2% of these lesions present in the head and neck [Cook et al, 1986;Lee and Lum, 1999;Gibbons et al, 2000;Leonard et al, 2001;Isaacson et al, 2009], with the skull base being a commonly reported site (temporal, sphenoid and ethmoid bones) and other sites including the mandible, maxilla, nasal cavity, thyroid, larynx, hyoid, tongue and the soft tissues of the neck. In the skull base the temporal bone is a common site of occurrence of GCTs.…”

A Giant Cell Granuloma of the Temporal Bone: A Case Report

“…MGCs of extracranial GCT and GCG are immunohistologically positive for CD 68, and shows histiocytic differentiation [6]. We also detected CD68 positive cells in the presented case, and P63 immunostaining may use differentiating GCTs from GCGs, and it is positive in GCT [7]. Negative P63 immunostaining indicated that the cells were not of epithelial origin.…”

“…The GCGs appear as an osteolytic lesion on skull radiography and has marginal sclerosis on CT [7]. Nackos, et al [8] published CT findings of 7 cases GCG, in which all 7 cases showed mixed density, and enhanced heterogeneously.…”

“…The GCG most often appears as a slowly growing mass. Mass effect, otalgia, a headache, hearing loss, and cranial nerve palsies (56%) are the most common presenting symptoms [7,8]. The presented patient applied with swelling and pain in the left temporomandibular area.…”

Diffuse-type giant cell tumor of the tendon sheath in the temporal region incidentally diagnosed due to a temporal tumor: A report of two cases and review of the literature

“…CT demonstrates an advantage in revealing the extent of disease, particularly in the bone cortex. The differences between D-GCTS and osteosarcoma or chondrosarcoma may be determined from the CT results (17,21), as diffuse thickening of soft tissues around the joints, oppressive absorption of the affected bones, the presence of a clear boundary, the lack of periosteal reaction and the presence of a soft tissue mass also without calcification or ossification may be observed on CT (13,21,22). MRI has an extremely high sensitivity and specificity for the diagnosis of G-GCTS (16,23).…”