Giant-cell tumour of bone

Abstract

Abstract. The radiological findings in 138 giant-cell tumours in 135 patients, with adequate clinical, radiological, and histological details, were studied. The purpose was to define the characteristic radiographic appearance of giant-cell tumour on presentation and after treatment and to assess whether radiological grading of the tumours was of value in determining prognosis. Most lesions were subarticular in location and eccentric to the long axis of the bone, had an ill-defined margin, and had eroded and expanded the overlying bony cortex. Half the lesions exceeded six cm in length along their long axis, contained a network of bony trabeculation, showed a linear periosteal reaction, and were accompanied by a soft-tissue mass. Rarely was the tumor margin sharply defined or was any sclerotic reaction evident in the adjacent bone. No individual radiological sign was of value in distinguishing tumours which would recur after treatment. However, lesions showing a combination of radiological signs suggesting slower growth did not recur.Postoperative resorption of a bone graft in the first year was observed several times in tumours which did not recur, whereas resorption of the graft after the first post-treatment year was usually associated with a recurrence of the tumour. Apparent consolidation of the lesion did not always denote healing. Recurrence in an apparently healed and consolidated lesion was not uncommon, particularly in the first two years after treatment. In a small group areas of radiolucency in an otherwise healed lesion persisted unchanged for many years.

Demonstration of Biological Aggressiveness of Bone Giant Cell Tumor by the Comparative Study of Immunohistochemical Detection of DNA-instability and Cortical Bone Destruction by CT.

“…This would mean that the histological grade III BGCT with apparent sarcomatous changes must be regarded as malignant and wide resection is a better choice of surgical treatment. As already pointed out by many authors [11,27,28,34], the present results also indicate that the radiographic grading of BGCT proposed by Campanacci et al [6] is of limited and uncertain value in indicating the prognosis. But among 5 BGCT cases of radiographical grade III with expansion of the tumor into the soft tissue, 2 cases showed local recurrence (case 1 and case 4) ( Table 2).…”

“…Williams et al [37] denied the significance of the normal mitotic counts proposed by King [25] and the histological grading by Jaffe et al [21] in evaluating the behavior of BGCT, staining that potentially aggressive or malignant BGCT are not initially distinguishable as such histologically. Campanacci et al [6] used radiographic criteria for grading BGCT, and Tehranzadeh et al [35] appreciated the radiographic grading as critically important in planning the management of this tumor, but many other authors concluded that radiological assessment of BGCT is of limited and uncertain value in indicating prognosis Eli, 27,28,34].…”

Curettage with cement augmentation of large bone defects in giant cell tumors with pathological fractures in lower-extremity long bones

“…This promotes healing of the fracture contrary to the belief that surgery will disseminate the tumor cells into the soft tissues and adjacent joint [26]. Our study had some limitations.…”

Multifocal osteoclastoma of the skull: case report

“…The most common radiological appearance of osteoclastoma in the skull is an expanding and/or lytic neoplasm that may appear to extend into the surrounding soft tissues, dura or sinuses. The rarity of these lesions explains the few numbers of MRI and CT descriptions of skull giant cell tumors 7,11 .…”