Giant cell tumour of tendon sheath pathology dermnet nz. Giant cell tumor of bone is a rare, locally aggressive tumor. The rank pathway is often reported to be involved in the pathogenesis of giant cell tumor of bone gctb. This pathway is a key signaling pathway of bone remodeling that plays a critical role in differentiation of precursors into multinucleated osteoclasts, and activation of osteoclasts. Giant cell tumour of bone gct is a bone neoplasm which is locally.
Second, occasionally, patients with tenosynovial giant cell tumours have indolent disease progression, with slow tumour growth or rare occurrence of osteochondral destruction of the involved joints. Symptoms may include joint pain, swelling, and limited movement. If tumour recurrence is inevitable once denosumab treatment is stopped. Giant cell tumour gct is a wellknown primary bone tumour, and its incidence in the mobile spine above the sacrum ranges from 1. Gct mostly affects people between the ages of 20 and 30 years old.
Although rarely lethal, benign bone tumors may be associated with a substantial disturbance of the local bony architecture that can be particularly troublesome in periarticular locations. Malignant transformation of a giant cell tumor of bone treated with denosumab. Giant cell tumor gct of bone is one of the commonest benign bone tumors encountered by an orthopedic. Management of spinal giant cell tumors the spine journal. Giant cell tumors gct are benign tumors with potential for. But pvns growths are fastgrowing and are more likely to interfere with movement and to spread within and around the joint. Marginal excision of giant cell tumor of the tendon sheath is the treatment of choice see the images below. Treatment of giant cell tumors is the excision of the tumor. Clinical outcome of recurrent giant cell tumor of the extremity in the. Historically, gctb have been treated primarily with surgery. Giantcell tumor of bone is a rare, locally aggressive tumor that typically occurs in the bones of skeletally mature young adults in. Jul 14, 2015 giant cell tumor of bone gctb is a rare tumor typically affecting the bones of skeletally mature young adults, with peak incidence in the third and fourth decades of life. Sabhlok s1, shaikh mi2, tripathy r3, mishra s4 abstract 1.
Giant cell tumor health encyclopedia university of. Current status and unanswered questions on the use of denosumab. These tumors are relativity common, particularly in the hands and fingers. They mostly occur in the long bones found in the arms and legs. Giant cell tumor is a relatively uncommon but painful tumor of bone, which can metastasize to the lungs. Giant cell tumors gcts are a rare etiology of head and neck tumors. Almost all patients who develop giant cell arteritis are over the age of 50. Treatment options the usual treatment for giant cell tumour of the tendon sheath is surgery to remove the tumour. Giant cell tumor definition of giant cell tumor by medical. Giant cell tumor of bone an overview abstract giant cell tumors gct are benign tumors with potential for aggressive behavior and capacity to metastasize. Because of their similar microscopic appearance, experts suggest that pvns may be a type of tenosynovial giant cell tumor. Goals of sgct treatment are tumor removal, spinal stability, and neural tissue decompression.
The aim of this study is to clarify the clinicopathological correlation of tumor and its relevance in. It is characterized by the presence of multinucleated giant cells osteoclastlike cells. Giant cell tumor gct of bone is generally a benign tumor composed. Although the term giant cell tumor implies that the multinucleated giant cells are responsible for the proliferative capacity of this tumor. Malignant transformation occurs in a small percentage of cases, usually following radiation therapy. Most often, the tumors occur close to the knee jointat the lower end of the thighbone femur or the upper end of the shinbone tibia. Giant cell tumors usually form in bones and are most often found in the knee. Curettage and reconstruction by the sandwich technique for. It will also depend on how severe the condition is. Spinal giant cell tumors sgcts are a locally aggressive benign bone tumor that can occur anywhere along the spine. How are giant cell tumors of the tendon sheath treated. Giant cell tumor is a one of the most common primary bone lesions in the distal phalanx. Pdf surgical treatment for giant cell tumor of bone.
Giant cell tumors are named for the characteristic way they look when viewed under the microscope. Giant cell tumors most often occur in young adults when skeletal bone growth is complete. The concern with giant cell tumors is that they can spread to other areas of the body and become cancerous tumors. The rank pathway is often reported to be involved this pathway is a key signaling pathway of bone remodeling. Giant cell tumor gct of bone was described by cooper and travers 1 in 1818. Malignant giant cell tumor of bone or soft tissue mgctbs is one of the malignant tumors associated with poor prognosis.
A giant cell tumor of tendon sheath gctts is a benign tumor consisting of many types of polygonal cells in a bed of collagen. Malignancy in giant cell tumor is uncommon and occurs in about 2% of all cases. The surgical excision of giant cell tumors is generally performed in an out patient surgery center. The goal for treatment of a giant cell tumor is to remove the tumor and prevent bone damage. In this study, we assessed the tumor changes induced by denosumab in a national multicentric series of 35 cases french bone pathology group networkresos.
A trend toward local recurrence and late malignant change with distant metastases, especially to the lung, has been reported 1, 2. The recurrence rate of patients who received first treatment. Treatment of giant cell tumor of the distal radius. Case report giant cell tumor of the maxilla in an 8 year old boy. The data of 20 patients with giant cell tumor localized in the distal radius were analyzed retrospectively. In this case, your doctor may recommend nonsurgical treatment. Diagnostic tests may include xrays, biopsy, and bone scans. Some physicians may attempt to inject the mass with cortisone in an attempt to shrink the mass. Thirteen of the patients were in the third or fourth decade of life. A giant cell tumor of bone is a type of benign noncancerous tumor that typically occurs in young adults between the ages of 20 and 40. Treatment of giant cell tumor of the distal radius request pdf. Although these tumors resemble their osseous counterparts, sequencing studies have suggested that these two may be genetically distinct.
Treatment options for recurrent giant cell tumors of bone. Most common in patients after 30 years old and it is the second most common benign hand tumor. B ligand rankl, has recently been introduced in the treatment strategy of giant cell tumor of bone. Central giant cell tumors cgcts of jawbones in pediatric patients present. Treatment for a giant cell tumor almost always involves surgery to remove the tumor and prevent damage to the bone near the affected joint. For giant cell tumors of bone, does radiotherapy provide a safe and effective treatment.
We searched pubmed and ovid when the study was being planned in 200506, with the terms giant cell tumor of bone, giant cell tumor, bone neoplasms, bone cancer, osteoclastoma, chemotherapy, radiation therapy, embolization, and surgery for publications in the english language related to treatment of patients with giant cell. Gct of tendon sheath is a circumscribed tumor that does not always arise from the tendon sheath but may arise from the synovium. Apr 17, 2015 giant cell tumor very rarely found in jaws. Treatment will depend on your symptoms, age, and general health. Also known as pigmented villonodular tumor of the tendon sheath pvnts. While a giant cell tumor can occur in any bone, it is most commonly located in the metaphysis or at the end epiphysis of the thigh bone femur or shin bone tibia. Malignant giant cell tumor of bone or soft tissue treated. Patient education giant cell tumor center for foot. Tumors are also called neoplasms, which means that they are composed of new and actively growing tissue. Giant cell tumors are named for the characteristic way. Giant cell tumour of the bone bone cancer research trust.
We searched pubmed and ovid when the study was being planned in 200506, with the terms giant cell tumor of bone, giant cell tumor, bone neoplasms, bone cancer, osteoclastoma, chemotherapy, radiation therapy, embolization, and surgery for publications in the english language related to treatment of patients with giantcell tumour of bone. First recognized in 1818 1, it was not until 1940 that gctb was formally distinguished from other tumors. Pdf giant cell tumor of bone an overview researchgate. Traditionally, surgery has been the mainstay of therapy. It can occur in any bone and can incur significant morbidity, due to a tendency to occur in the bones surrounding the wrist and knee, as well as the axial skeleton. Giant cell tumor of the bones of the hand and foot. Abstractnineteen patients who had a giant cell tumor of the pelvis were managed from 1944 through 1989. Jan 25, 2015 giant cell tumor is a relatively uncommon but painful tumor of bone, which can metastasize to the lungs. It usually develops in long bones but can occur in unusual locations.
Treatment of tenosynovial giantcell tumour types the lancet. Pdf giant cell tumors gct are benign tumors with potential for aggressive. It is defined as a highgrade sarcoma originating in a giant cell tumor gct and seems to behave less aggressively than its secondary. Moreover, it could share some features with other giant cell rich lesions involving the hand and foot, and this may affect the differential diagnosis. This study evaluates the clinical, radiological and pathological findings in five cases of gctb of the distal forearm where a 3 month course of denosumab was given prior to surgery. Giant cell tumor is one of the more common benign bone tumors. Malignancy in giant cell tumor of bone american cancer society. Denosumab in patients with giantcell tumour of bone. Intraoperative photograph of same giant cell tumor of distal radius as in previous two images shows wrist arthrodesis with fibular autograft and 16hole lowcontact dynamic compression lcdc plate. Giant cell tumors are usually found in the long bones, most often the distal femur, proximal tibia, and distal radius. Factors affecting the recurrence of giant cell tumor of bone after.
These benign neoplasms mainly affect the long bones. If a tumor cannot be removed through surgery, newer. Giant cell tumor of soft tissue of the nasopharynx. Treatment of tenosynovial giantcell tumour types the. Treatment guidelines are less clear for this tumor type compared to giant cell tumor of the bone. There is no widely held consensus regarding the ideal treatment method. Mar 29, 2019 its appearance is very similar to that of tenosynovial giant cell tumor under a microscope. Giant cell tumor of bone gctb is a relatively rare, benign, but locally aggressive osteolytic skeletal neoplasm of young adults. Sep 03, 2019 many authors reported a strong association between radiation therapy and malignant transformation of the giant cell tumor gct.
The following list of medications are in some way related to, or used in the treatment of this condition. A patients poor medical health and the presence of lifethreatening illnesses are. It involves the joint fluid sac, tendon sheath, and synovial. Pdf giant cell tumors gct are benign tumors with potential for. However, it remains controversial whether the combined treatment of both sur. Giant cell tumor of the bone gctb is classified as an intermediate, locally aggressive but rarely metastasizing tumor. Giant cell tumors gct are benign tumors with potential for aggressive behavior and. They are always found at the end of the bone next to the joint. A benign nodular tumor that is found on the tendon sheath of the hands and feet. Moreover, it could share some features with other giant cell. Management of spinal giant cell tumors sciencedirect. It is locally aggressive and prone to recurrence and malignant transformation.
It usually develops near a joint at the end of the bone. Although they are benign, gct can grow fast and damage the affected bone and spread to the soft tissue around it. Peripheral giant cell granuloma common tumor like growth in the oral cavity. The standard treatment for giant cell tumors typically includes surgery to remove as much of the tumor as possible and bone reconstruction, if needed. Giant cell tumor gct of bone is generally a benign tumor composed of mononuclear stromal cells and characteristic multinucleated giant cells that exhibit osteoclastic activity. At present, surgery is the primary treatment method for gctb. Case report giant cell tumor of the maxilla in an 8 year. Nov 20, 2000 giant cell tumor of the small bones of the hand and foot is suspected of having some peculiar features compared with giant cell tumor in other sites.
The goal for treatment of a giant cell tumor is to remove the tumor. Denosumab, an antibody directed against receptor activator of nuclear factor. Primary malignancy in giant cell tumor pmgct is rare. A giant cell tumor gct, also known as an osteoclastoma, is a relatively common, generally benign but aggressive and destructive tumor of bone that typically affect females slightly more commonly than males within the ages of 2040 years old, following skeletal maturity. The most common location of a giant cell tumour of the bone is around the knee joint where over 50% of giant cell tumours arise4. Giant cell tumor of the small bones of the hand and foot is suspected of having some peculiar features compared with giant cell tumor in other sites. We will decide on the best treatment for you depending on a number of factors. However, if malignant degeneration does occur, it is likely to metastasize to the lungs. Complete surgical resection is the gold standard treatment. Giant cell tumor of tendon sheath is also named tenosynovial giant cell tumor. Giant cell tumor is one of the more common benign bone tumors, occurring in adults ages 20 40 years. Sep 16, 2018 learn indepth information on giant cell tumor of tendon sheath, its causes, symptoms, diagnosis, complications, treatment, prevention, and prognosis. Giantcell tumor of bone is a rare, locally aggressive tumor that typically occurs in the bones of skeletally mature young adults in their second to fourth decades.
A giant cell tumor is one that is made up of a large number of benign noncancerous cells that form an aggressive tumor. Giant cell tumor of the bone gctob, is a relatively uncommon tumor of the bone. Giant cell tumours of the bone can also start in the pelvis, the spine, the. Radiation therapy for giant cell tumors of bone request pdf. Surgery is the preferred treatment for giant cell tumors. Tenosynovial giant cell tumors are benign not dangerous, slowgrowing tumors that affect joints in the fingers, hands, arms, shoulders, or legs. List of giant cell tumor of bone medications 2 compared. Embolization therapy to curtail hemorrhage and insertion of cement. Giant cell arteritis gca is the most common form of vasculitis that occurs in adults. Treatment of giant cell tumour of bone gctb of the distal radiusulna poses a surgical challenge, as complex reconstructive surgery may be required. Combining twostage surgery and denosumab treatment in a.
Giant cell tumor of bone gctb is a benign but locally. Pediatric giant cell tumor gct of bone is rare and the course of the disease in the immature skeleton is sparsely described. The tumour nodule is comprised of a population of oval cells set in a minor condensed eosinophilic fibrous stroma figures 4 and 5. Treatment options for recurrent giant cell tumors of bone article in journal of cancer research and clinical oncology 51.
The clinical behavior and treatment of giant cell tumor of bone is still perplexing. The goals of treatment are eradication of the tumor, preservation of limb. We performed a retrospective study addressing symptoms, treatment, and outcome in children with gct. Cytochemical and ultrastructural changes in the osteoclastlike giant cells of giant cell tumor of bone following bisphosphonate administration. Scanning power view of giant cell tumour of tendon sheath identifies a well circumscribed tumour nodule arising in the deep dermis or subcutis figures. The biological features of tenosynovial giant cell tumours need to be considered when selecting the treatment modality. It was with great interest that we read the international retrospective research by monique mastboom and colleagues1 in the lancet oncology, in which surgical outcomes and recurrence risk factors of patients with diffusetype tenosynovial giant cell. The reported incidence of gct in the oriental and asian population is higher than that in the caucasian population and may account for 20% of all skeletal neoplasms. Coley 3 reported a series of 50 cases in which the diagnosis was benign giant cell tumor and. Giant cell tumor accounts for 5 to 9 percent of all primary bony tumors. Giant cell tumor of bone, local recurrence, p63, prognostic marker introduction giant cell tumor of bone gct is a primary bone tumor. Giantcell tumor of the bone gctob, is a relatively uncommon tumor of the bone.
Giant cell tumors are rare tumors that develop when many benign noncancerous cells group together and form a large mass. Giant cell tumours gct are benign noncancerous tumours that develop in the bone. Traditionally, surgery has been the mainstay of therapy for this disease, but the disease can recur even with optimal procedures. Postoperative lateral radiograph of same giant cell tumor of distal radius as in preceding image. Giant cell tumor of bone an overview the archives of bone and. Giant cell tumor gct of bone is one of the commonest benign bone tumors encountered by an orthopedic surgeon. Please remove adblock adverts are the main source of revenue for dovemed. Two hundred and fourteen patients with benign giant cell tumor of bone gctb, treated from 1980 to 2007 at the department of orthopedics of the university of muenster germany, were analyzed in a retrospective study. The goals of any sgct resection are to remove as much tumor as possible, decompress the neural elements. The exact cause of giant cell tumors remains unknown.
476 1405 837 1538 1117 175 371 415 501 766 889 1577 1227 293 730 401 114 543 1623 967 1144 995 1224 750 1000 566 945 346 258 411 646 57 1358 60 1549 964 385 1081 732 1029 1265 693 1138 1189 189 796