Cases reported "Giant Cell Tumor of Bone"

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1/13. Pseudoanaplastic giant cell tumor of bone.

    Marked nuclear atypia can be found in a variety of benign mesenchymal tumors, including ancient schwannomas, symplastic leiomyomas, osteoblastomas, and chondromyxoid fibromas. Such nuclear atypia is believed to represent a degenerative phenomenon and does not indicate aggressive behavior. Separation of these pleomorphic but benign lesions from true sarcomas may be difficult. We are aware of only one prior description of such degenerative atypia in benign giant cell tumor of bone. We report a benign giant cell tumor of bone arising in the sacrum of a 21-year-old white female. Preoperative embolization of this lesion had been performed, and subsequent curetting revealed marked atypia suggestive of an anaplastic malignancy. However, only very rare mitotic figures were present, and the radiographs were consistent with a benign giant cell tumor. A diagnosis of benign giant cell tumor was made, and no recurrence or metastases have been observed during the 4-year postoperative period.
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2/13. Fine-needle aspiration cytologic diagnosis of giant-cell tumor of the sacrum presenting as a rectal mass: A case report.

    A giant-cell tumor of the sacrum is rare, and poses significant therapeutic and surgical difficulties largely because of its location. patients usually present with pain in the lower back radiating to one or both lower limbs, with or without neurological deficit. The index case presented with difficulty in defecation, in addition to pain in both lower limbs for 6 mo. The patient was seen to have a rectal mass, and a per-rectal fine-needle-aspiration was performed. The smears showed a cellular aspirate composed of a large number of osteoclastic giant cells, admixed intimately with clusters and a scattered population of mononuclear cells. Mitotic figures were not observed. Although the differential diagnosis of osteoclastic giant cell-containing lesions is broad, the presence of strong cohesiveness between the mononucleated cells and giant cells in cohesive clusters is a very helpful diagnostic feature, and was a prominent finding in the present case.
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3/13. Primary malignant giant cell tumour of sacrum--a case report.

    A rare case of primary malignant GCT of sacrum in a 35-year-old female is reported.
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4/13. The treatment of sacral giant-cell tumours by serial arterial embolisation.

    Giant-cell tumours of the sacrum are difficult to treat. Surgery carries a high risk of morbidity, local recurrence and mortality. radiation is effective in some patients, but has a risk of malignant change. We evaluated the effectiveness of serial arterial embolisation as an alternative to surgery. Five patients with giant-cell tumours of the sacrum which had been primarily treated by serial embolisation were retrospectively reviewed for changes in the size of the tumour. In four the symptoms resolved with full return of function and arrest in the growth of the tumour. They remained free from growth, recurrence, or metastases at follow-up (4 to 17 years). One patient died from metastatic disease within 18 months of the initial diagnosis.
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5/13. Multifocal metachronous giant cell tumor in a 15-year-old boy.

    We report a case of multifocal metachronous giant cell tumor (GCT) that involved the fibula, tibia, and sacrum of a 15-year-old boy. Multifocal GCT of bone presenting in children is an exceedingly rare phenomenon; however, there is evidence that multifocal GCT presents, on average, at a younger age than solitary GCT. Pediatric radiologists should be aware of this when encountering a single lesion with characteristic radiographic features of GCT and when encountering multiple lytic skeletal lesions.
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6/13. A large giant cell tumor of the sacrum. Advantage of an abdomino-sacral approach.

    We report a case of giant cell tumor of the sacrum, presenting with sacral pain, swelling, and change of bowel habits. Rectal examination revealed a huge retrorectal mass fixed to the sacrum but not to the wall of the rectum. Abdominal ultrasonography, computed tomography CT scan, and magnetic resonance imaging MRI showed a huge pelvic mass invading the sacrum. Exploration via posterior sacral approach was not successful due to both, extensive bleeding and difficult accessibility. Re-exploration was carried out 2 days later with the patient in lithotomy position. Using abdomino-sacral approach the mass together with part of the sacrum and the whole coccyx were excised. Histopathology reported giant cell tumor of the sacrum with no evidence of mitosis. The patient was symptomless 12 months after surgery and on follow up.
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7/13. curettage and radiotherapy of giant cell tumour of the sacrum: a case report with a 10-year follow-up.

    A case report of a 53-year-old woman with giant cell tumour of the sacrum is presented. Initial curettage was performed through a posterior approach and the patient was relieved of pain and discharged. However, 6 months later the patient was readmitted with a tumour that had progressed towards the L5 vertebra. A further curettage followed by adjuvant radiotherapy resulted in successful reduction of the tumour. Ten years after the operation, there was no recurrence or metastasis.
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8/13. Giant-cell tumors of the cervical spine: case report.

    OBJECTIVE: Giant-cell tumors of bone are rare, benign neoplasms that occur infrequently in the spine above the sacrum, and their presence in the cervical vertebrae is even more exceptional. Although complete en bloc surgical resection is difficult in the cervical spine, treatment with adjuvant radiotherapy has been considered controversial because of a small risk of malignant transformation. The authors report two cases of giant-cell tumors in the cervical vertebrae that were treated successfully with surgical excision and postoperative radiation as well as long-term follow-up. CLINICAL PRESENTATION: Both patients presented with neck pain radiating into the upper extremities. In both cases, plain radiography, computed tomographic scanning, and magnetic resonance imaging revealed a large destructive process in the vertebral body. INTERVENTION: In one case, the tumor was treated by anterior resection, then by laminectomy and instrumented fusion, and finally by adjuvant postoperative radiotherapy. In the second case, treatment consisted of radical anterior and posterior resection with instrumented fusion. However, the tumor recurred, and, after several surgical procedures, external beam radiotherapy was administered. The patients have been followed for 17 and 11 years, respectively, with no evidence of tumor recurrence. CONCLUSION: Radical resection of giant-cell tumors is generally agreed to be the best treatment option. However, complete resection is often not a feasible option for tumors in the cervical spine because of involvement of critical neurovascular structures. In these cases, the benefits of radiotherapy to reduce the risk of local recurrence may well outweigh concerns about the treatment's theoretical risks.
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9/13. Malignant transformation in a fatal case of giant cell tumour of the sacrum.

    Most giant cell tumours can be treated by local surgery and only rarely are they life threatening. We report a case of a giant cell tumour of the sacrum causing irresectable and fatal small bowel obstruction following malignant transformation of the tumour. The role of radiotherapy in this transformation is discussed.
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10/13. Case report 869. Benign metastasizing giant cell tumor of bone.

    We presented a case of giant cell tumor of the sacrum with multiple pulmonary metastases in an 11-year-old girl. To the best of our knowledge, our patient is the youngest reported patient with a giant cell tumor with pulmonary metastases. Although giant cell tumor of bone with pulmonary metastases is extremely rare, this entity must be considered in the differential diagnosis of bone tumors.
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