Giant Cell Tumour
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http://www.emedicine.com/Radio/topic307.htm
Giant Cell Tumor
Last Updated: June 6, 2002
Author: Lesley-Ann Goh, MBBS, FRCR, Consultant, Department of Diagnostic Radiology, National University Hospital
Coauthor(s): Wilfred CG Peh, MBBS, MHSM, MD, FRCPE, FRCPG, FRCR, Clinical Professor, Faculty of Medicine, National University of Singapore; Senior Consultant Radiologist, Programme Office, Singapore Health Services; Tony WH Shek, MBBS, FRCPA, Honorary Clinical Assistant Professor, Department of Pathology, University of Hong Kong
Background: Giant cell tumor of the bone is a relatively uncommon tumor. It is characterized by the presence of multinucleated giant cells. The tumor is usually regarded as benign. In most patients, giant cell tumors have an indolent course, but tumors recur locally in as many as 50% of cases. Metastasis to the lungs may occur.
Cooper first reported giant cell tumors in the 18th century. In 1940, Jaffe and Lichtenstein defined giant cell tumor more strictly to distinguish it from other tumors. Giant cell tumor usually occurs de novo but also may occur as a rare complication of Paget disease of the bone
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http://bonetumor.org/tumors/pages/page106.html
BoneTumor.org
Giant cell tumor accounts for 5 to 9 percent of all primary bony tumors and may be the most common bone tumor in the young adults aged 25 to 40. Giant cell tumor is are found more commonly in women than men, and occur most often during the third decade (1). Giant cell tumors are usually found in the long bones, most often the distal femur, proximal tibia, and distal radius. Giant cell tumor is a one of the most common primary bone lesions in the distal phalanx. Whether that tumor arises in the epiphysis or distal metaphysis is a matter of controversy, but giant cell tumors only occur after the epiphyseal plates have closed and a diagnosisof GCT in a patient with open growth plates should be questioned.
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http://www.wheelessonline.com/ortho/giant_cell_tumor_of_bone
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 occupy most of epiphysis & adjacent metaphysis;
- tumor may erode & penetrate subchondral bone, articular cartilage, & cruciate ligaments;
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http://www.emedicine.com/orthoped/topic121.htm
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Introduction
Giant cell tumors of the tendon sheath are the second most common tumors of the hand, with simple ganglion cysts being the most common. Chassaignac first described these benign soft-tissue masses in 1852, and he overstated their biologic potential in referring to them as cancers of the tendon sheath.
Giant cell tumors of the soft tissue are classified into the common localized type and the rare diffuse type. The rare diffuse form is considered the soft tissue counterpart of diffuse pigmented villonodular synovitis (PVNS). The diffuse form typically affects the lower extremities. Its anatomic distribution parallels that of PVNS, with lesions most commonly found around the knee, followed by the ankle and foot. However, the diffuse form occasionally affects the hand. Typically, these lesions, like those of PVNS, occur in young patients; the condition is diagnosed in one half of the patients before they are aged 40 years. The diffuse form is often locally aggressive, and multiple recurrences after their excision are common.
Because of the similarity in patients' ages, tumoral locations, clinical presentations, and symptoms in PVNS and the diffuse form of giant cell tumors of the tendon sheath, the diffuse form probably represents an extra-articular extension of a primary intra-articular PVNS process. Findings from flow cytometric DNA analysis suggest that PVNS and giant cell tumors of the tendon sheath are histopathologically similar but clinically distinct lesions. When the origin of these poorly confined soft-tissue masses is uncertain, Enzinger and Weiss classify these tumors as the diffuse type of giant cell tumors of the tendon sheath, whether or not they involve the adjacent joint.
This article focuses on the common localized form of giant cell tumors, that is, the giant cell tumors of the tendon sheath that often are found in the hands and feet.
Author: James R Verheyden, MD, Consulting Surgeon, Department of Orthopedic Surgery, The Orthopedic & Neurosurgical Center of the Cascades
Coauthor(s): Timothy A Damron, MD, David G Murray Professor, Department of Orthopedic Surgery, Upstate Medical University; Professor, Orthopedic Oncology and Adult Reconstruction, Department of Orthopedics, State University of New York at Syracuse
eMedicine 2002
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Giant Cell Tumor
Pre-test and tutorial
Frank J. Frassica, MD
Professor of Orthopaedics & Oncology
Johns Hopkins University
Department of Orthopaedic Surgery
Baltimore, Maryland
Franklin H. Sim, MD
Chief, Section of Orthopedic Oncology
Mayo Clinic
Rochester, Minnesota
Section of Orthopedics Hyperguide
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http://en.wikibooks.org/wiki/Diagnostic_Radiology/Musculoskeletal_Imag ...
Giant cell tumors of the bone are uncommon bone tumors which represent around 4-5% of primary bone tumors and 18% of all benign bone lesions. They are interesting in the fact that their classic radiographic appearance is easily identifiable.
Giant cell tumors can either be benign or malignant, although the majority of them are benign. Radiographically, benign versus malignant tumors are difficult to distinguish. In most patients, the tumor has an indolent course, but repeated local recurrence of the tumor does happen. Approximately 5% of giant cell tumors are defined as malignant. Malignancy usually occurs as the result of malignant transformation after radiation therapy.
These tumors are slightly more common in females, with 50-57% of cases occurring in females. The general age range for giant cell tumors is 20-40 years old. Approximately 85% of tumors occur in the long bones, namely the distal femur, proximal tibia, proximal humerus, and distal radius. Another location typical of giant cell tumor is the spine, particularly the sacrum. Spinal involvement is typically in the vertebral body, although its location is variable.
Clinical presentation is nonspecific, and it usually is pain at the tumor site. Pathologic fracture occurs around 10% of the time. Local mass effect can cause a range of symptoms, for example, from posterior expansion into the spinal canal.
Diagnostic Radiology/Musculoskeletal Imaging/Tumors Basic/Giant cell tumor
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