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giant cell tumor of bone (osteoclastoma)

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 origin constitute the neoplastic cells - multinucleated giant cells (osteoclasts) are secondarily recruited & along with mononuclear histiocytic cells comprise the non-neoplastic cell population Radiology: - radiographs - lytic/lucent lesions - soap-bubble appearamnce - non-sclerotic, sharpy defined border - chest X-ray or CT of thorax to assess metastasis - MRI useful to evaluae intramedually & soft-tissue extension Complications: - pathologic fracture - metastasis (5%) usually to lung 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 tumor-induced osteolysis - Denosumab targeting the RANK ligand (RANKL) is experimental

General

bone neoplasm

References

  1. Wikipedia: giant cell tumor of bone http://en.wikipedia.org/wiki/Giant_cell_tumor_of_bone
  2. Klenke FM et al Giant Cell Tumor of Bone: Risk Factors for Recurrence. Clin Orthop Relat Res. 2010 Aug 13. PMID: 20706812
  3. Karpik M. Giant Cell Tumor (tumor gigantocellularis, osteoclastoma) - epidemiology, diagnosis, treatment. Ortop Traumatol Rehabil. 2010 May-Jun;12(3):207-15. Review. PMID: 20675862
  4. Thomas DM, Skubitz KM. Giant cell tumour of bone. Curr Opin Oncol. 2009 Jul;21(4):338-44. Review. PMID: 19444102
  5. Pathology outlines http://pathologyoutlines.com/bone.html#giantcelltumor

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