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Osteoclastoma

Bone Giant Cell Tumor


Presentation

  • Classical manifestations of the disease are present in about 15-20% of patients.[ncbi.nlm.nih.gov]
  • Increasing pain at the tumor site is the most common presenting symptom. Three types of GCT can be distinguished radiographically according to the Cappanacci or Enneking classification.[ncbi.nlm.nih.gov]
  • Abstract This paper has described an unusual case of osteoclastoma of the petrous temporal bone which presented with multiple cranial neuropathies.[ncbi.nlm.nih.gov]
  • Abstract A case of osteoclastoma like giant cell tumour of thyroid is reported in a patient who presented with dysphagia and swelling in the neck.[ncbi.nlm.nih.gov]
  • Case presentation Clinical presentation A 26 year old male was admitted with impaired hearing and tinnitus on the right side and swelling of the right temporal region which was gradually progressive for the last two years.[doi.org]
Hyperthermia
  • Int J Hyperthermia 13(3):287–306 PubMed CrossRef Google Scholar Nicholson NC, Ramp WK, Kneisl JS, Kaysinger KK (1998) Hydrogen peroxide inhibits giant cell tumor and osteoblast metabolism in vitro.[doi.org]
Camping
  • […] cells (osteoclasts) and a minor population of mononuclear cells. [125I]-sCT competitive binding studies indicated a Kd of 5 x 10(-10) M and receptor number of approximately 1 million sites/osteoclast. sCT treatment resulted in a dose-dependent rise in cAMP[ncbi.nlm.nih.gov]
Pharyngitis
  • Once again, the pharyngeal wall ruptured. Reconstruction of the posterior pharyngeal wall and the anterior column of the spine was performed with an osteocutaneous fibular flap from the skull base to C3.[ncbi.nlm.nih.gov]
Tinnitus
  • Case presentation Clinical presentation A 26 year old male was admitted with impaired hearing and tinnitus on the right side and swelling of the right temporal region which was gradually progressive for the last two years.[doi.org]
Diplopia
  • GCT of the sphenoid may present with headache, visual field defects, blindness, diplopia, second through eighth cranial nerve dysfunction, endocrinopathy and change of mental status [ 4 ].[doi.org]
Ptosis
  • A large mass in the right orbit, causing proptosis, ptosis of the right upper eyelid, and limitation to eye movements, was surgically removed from a 51-year-old woman suffering from Paget's bone disease (PBD).[ncbi.nlm.nih.gov]
Bony Swelling
  • Figure 1: Bony swelling anteromedial aspect of proximal left thigh (margins if swelling marked by*) with abduction deformity of left lower extremity Click here to view Neurological examination of lower extremity was normal without any neurodeficit.[jscisociety.com]
Suggestibility
  • The lack of junctional complexes or other obvious epithelial elements suggested mesenchymal origin.[ncbi.nlm.nih.gov]
  • It is suggested that the giant cells are made up of merged matrix cells.[ncbi.nlm.nih.gov]
  • Instead, the evidence suggests the formation of giant cells through a mechanism of cellular fusion.[ncbi.nlm.nih.gov]
  • These data suggest that purinergic agonists may play a role in the regulation of bone metabolism.[ncbi.nlm.nih.gov]
  • This suggests that a diagnosis of HPTo is difficult nowadays. Therefore, determination of serum calcium concentration and other markers of calcium and phosphate metabolism should be obligatory in patients with bone lesions.[ncbi.nlm.nih.gov]
Cranial Neuropathy
  • Abstract This paper has described an unusual case of osteoclastoma of the petrous temporal bone which presented with multiple cranial neuropathies.[ncbi.nlm.nih.gov]

Workup

  • Correct modern preoperative neuroimaging workup, coupled with microneurosurgical technique, allowed successful lesion removal with good outcome.[ncbi.nlm.nih.gov]
  • There is an 18% incidence of multicentric foci indicating that a bone scan should be a part of routine workup of these tumors 2. Overall they appear in a younger age group and recur more rapidly in the hand than they do in other locations.[ispub.com]
Atelectasis
  • In our case, a 40-year-old male patient, such a tumor was found in the left upper lobe bronchus with atelectasis due to bronchial obstruction. Upper lobe resection was done. As far as we know, this has not been reported.[ncbi.nlm.nih.gov]

Treatment

  • All patients had quantitation of pre-treatment tumour volume and post-treatment response using a radiographic grid. CT scan measurements have complimented the grid quantitation in recent years.[ncbi.nlm.nih.gov]
  • Surgery is the mainstay of treatment and usually consists of intralesional curettage; local control rates range from 80% to 90% after this procedure.[ncbi.nlm.nih.gov]
  • The mainstay of treatment is total mechanical removal with curettage.[ncbi.nlm.nih.gov]
  • The treatment rationale for this particular patient was extrapolated from the treatment of giant cell tumor in other more commonly involved bones.[ncbi.nlm.nih.gov]

Prognosis

  • Although rare ( 5%), lung metastases are possible and have an excellent prognosis. Hence, this entity has been called benign metastasising giant cell tumor 10,11 .[radiopaedia.org]
  • The so-called variants, which in general have a favorable prognosis, are easily distinguishable from true giant-cell tumors. 3.[journals.lww.com]
  • The prognosis of patients with multiple primary malignant tumors may be determined independently by the stage of each malignancy.[spandidos-publications.com]
  • The condition, its prognosis and various treatment modalities were discussed with the patient and his family. Because of extensive involvement of talus, total talectomy with tibiocalcaneal arthrodesis was planned.[faoj.org]

Etiology

  • - Discussion: - a common benign but locally aggressive lesion of unknown etiology; - occurs chiefly in men between 20-50 yrs (after epiphyseal closure); - tumor is expansile lytic lesion that involves the epiphysis & metaphysis; - tumor may enlarge to[wheelessonline.com]
  • Etiology The exact origin is still unknown, but data obtained from ultrastructural analyses and cell cultures, as well as novel molecular data, suggest that the stromal cell, or mononuclear spindle cell, is neoplastic.[atlasgeneticsoncology.org]
  • Additionally, Schottenfeld ( 9 ) believed that the two neoplasms may possess a shared etiology if the incidence of a subsequent neoplasm is significantly higher among those with a previous primary cancer.[spandidos-publications.com]
  • North Bengal Medical College, Darjeeling,West Bengal Sankarshan Bhaduri Asit Chandra Ray Keywords: Giant cell tumor, metacarpal, FNAC Abstract Giant cell tumor (GCT) or osteoclastoma is a common benign tumor which is locally aggressive and is of unknown etiology[pacificejournals.com]

Epidemiology

  • [Article in English, Polish] Author information 1 Department of Clinical Orthopaedics and Traumatology, Medical University Hospital in Białystok. mkarpiky@op.pl Abstract The author presents the epidemiology, classification, clinical features and strategies[ncbi.nlm.nih.gov]
  • From Epidemiology relatively uncommon 4-5% of primary bone tumors 20% of benign bone tumors higher incidence in Asia Pathology multinucleated giant cells ( osteoclasts or osteoclast -like) generally benign giant cell tumour stromal cells of osteoblastic[anvita.info]
  • ., Schuetze, S.M. and Schwartz, K. (1975) The Epidemiology of Malignant Giant Cell Tumors of Bone: An Analysis of Data from the Surveillance, Epidemiology and End Results Program (1975-2004). [ 6 ] Campanacci, M., Baldini, N., Boriani, S. and Sudanese[scirp.org]
  • Epidemiology [ edit ] Giant-cell tumor of the bone accounts for 4-5% of primary bone tumors and about 20% of benign bone tumors. [14] However, significantly higher incidence rates are observed in Asia, where it constitutes about 20% of all primary bone[en.wikipedia.org]
  • […] surgery or low dose radiation therapy (more common than primary malignant giant cell tumor of bone) ICD coding D48.0 : Giant cell tumor of bone, NOS (uncertain whether benign or malignant) C40, C41 : Giant cell tumor of bone, malignant, primary site Epidemiology[pathologyoutlines.com]
Sex distribution
Age distribution

Pathophysiology

  • Other bones (proximal sacrum, vertebrae, skull base) may be involved, and any bone may be affected 95% are unifocal Uncommon in hands / feet (more likely to be giant cell lesion of the small bones), jaw (more likely to be central giant cell granuloma ) Pathophysiology[pathologyoutlines.com]

Prevention

  • Osteoclastoma rarely involves the vertebrae, and treatment, whether by surgery or radiotherapy, seldom results in eradication of the lesion or prevention of recurrence.[ncbi.nlm.nih.gov]
  • Differential-diagnosis osteosarcoma chondroblastoma osteoid osteoma osteoblastoma bone cyst brown tumor of hyperparathyroidism Management surgery if tumor is resectable curettage is most common technique zoledronate is thought to induce osteoclast apoptosis , preventing[anvita.info]
  • Treatment for a giant cell tumor almost always involves surgery to remove the tumor and prevent damage to the bone near the affected joint. Giant cell tumors are named for the characteristic way they look when viewed under the microscope.[orthoinfo.aaos.org]
  • […] preserved in the area of minimum damage, which was treated by electrocoagulation together with the cavity) together with bone grafting and intramedullary reinforcement of the affected bone (which provides stable osteosynthesis, early mobilization, and prevention[aip.scitation.org]

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