Giant cell tumour of bone: morphological, biological and histogenetical aspects

Abstract

The giant cell tumour of bone (GCT) is a locally aggressive intraosseous neoplasm of obscure biological behaviour. Although well defined in clinical, radiological and histological terms, detailed information on its biological development is still relatively incomplete. The tumoral tissue consists of three cell types -the neoplastic giant cell tumour stromal cells (GCTSC), representing the proliferative fraction, secondarily recruited mononuclear histiocytic cells (MNHC) and multinuclear giant cells (MNGC). These cellular components interact together with factors that have a role in regulating osteoclast function in normal bone tissue (e.g. RANK, RANKL, OPG, M-CSF). Recent publications suggest that the neoplastic stromal cells express differentiation features of mesenchymal stem cells. Further research of the pathogenesis of GCT as well as the complex interactions of its cellular populations may provide the knowledge necessary for developing approaches for a biological-based therapy of this neoplasm.Résumé Les tumeurs à cellules géantes (GCT) sont des tumeurs localement agressives de type néoplasme intra osseux don't les mécanismes biologiques restent relativement obscurs. Cependant si ces tumeurs sont bien définies sur le plan clinique, radiologique et histologique, les détails marquants de leur développement biologique restent inconnus. Le tissu tumoral consiste en un stroma de tumeurs à cellules géantes (GCTSC) qui représente la partie prolifér-ative de la tumeur avec adjonction secondaire de cellules de type histogitaire mononuclées (MNHC) et de cellules géantes (MNGC). Ces composants cellulaires interagissent avec un certain nombre de facteurs régulant l'action ostéoclastique du tissu osseux normal (e.g. RANK, RANKL, OPG, M-CSF). De récentes publications permettent de penser que ce stroma cellulaire de type néoplasique exprime une différenciation de cellules mésenchymateuses. De prochaines recherches sur la pathogénèse des tumeurs à cellules géantes ainsi que sur les interactions complexes des différentes populations cellulaires devraient permettre d'approcher un traitement médical pour ce type de néoplasme.

Clinical effects of three surgical approaches for a giant cell tumor of the distal radius and ulna

“…The disease often occurs in adults between the ages of 20-and 40-years-old, with a higher incidence in females (2,3). GCTs are generally composed of mononuclear histiocytic cells, multinucleated giant cells resembling osteoclasts and neoplastic stromal cells that are the predominant proliferating cell population (4,5). The disease is generally recognized as a border or low-grade, with a certain degree of invasive characteristics, demonstrated by biological behavior (6,7).…”

Stimulation of Osteogenic Differentiation in Stromal Cells of Giant Cell Tumour of Bone by Zoledronic Acid

“…Stromal cell (GCTSC) is thought to be the primary neoplastic cells owing to their abilities of stable proliferation in culture and tumor formation in mice (Cowan and Singh, 2013). It expresses differentiation features of mesenchymal lineage and pre-osteoblast phenotype (Werner, 2006). Mononuclear cell expresses CD68-antigen so as to be considered originating from monocytic-histiocytic system (Zheng et al, 2001).…”

Recurrent Giant Cell Tumor of Long Bones: Analysis of Surgical Management

“…Tumors arise in the metaepiphyseal region of long bones, predominantly in the distal femur and the proximal tibia, but they can occur in the entire skeleton [7]. Histologically, these tumors are classified as a benign neoplastic lesion consisting of three cell types: mononuclear histiocytic cells, multinucleated giant cells that resemble osteoclasts, and neoplastic stromal cells [2,19,46,48].…”