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Amoodi H, Al-Domaidat D, Danish A, Alshaikh Hasan R. Giant Cell Tumor of the Temporal Bone and Skull Base. J Craniofac Surg 2023; 34:e628-e630. [PMID: 37236622 DOI: 10.1097/scs.0000000000009432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/10/2023] [Indexed: 05/28/2023] Open
Abstract
Giant cell tumor (GCT) is a benign tumor that originates from undifferentiated mesenchymal cells of the bone marrow. The craniums as well as temporal bone are extremely rare locations for GCTs. Clinical, radiological, and anatomical diagnosis of this locally aggressive disease poses a major challenge in clinical practice. In this article, we present a clinical study for a 35-year-old female who was found to have left-sided temporal bone GCT with extension to middle cranial fossa and temporomandibular joint (TMJ) with its clinical features and management.
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Affiliation(s)
- Hosam Amoodi
- Otolaryngology Department, Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
- Department of Surgery, Jeddah University, Jeddah, Saudi Arabia
| | - Derar Al-Domaidat
- Otolaryngology Department, Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
| | | | - Ro'a Alshaikh Hasan
- Internal Medicine Department, Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
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Chanda R, Regi SS, Kandagaddala M, Irodi A, Thomas M, John M. Imaging Features of Craniofacial Giant Cell Granulomas: A Large Retrospective Analysis from a Tertiary Care Center. AJNR Am J Neuroradiol 2022; 43:1190-1195. [PMID: 35798384 PMCID: PMC9575421 DOI: 10.3174/ajnr.a7568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 05/24/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Craniofacial giant cell granulomas are rare lesions with varied appearances on imaging. We aimed to describe the imaging features of giant cell granulomas of the craniofacial bones. MATERIALS AND METHODS A retrospective analysis of the clinical features and imaging findings of 20 histopathology-proved cases of craniofacial giant cell granulomas, dating from 2006 to 2022, was performed. RESULTS Of the 20 cases, 10 each were seen in men and women. The epicenter of the lesions varied in location: in the maxilla in 8 patients, in the mandible in 5, in the temporal bone in 3, in the sphenoid/clivus in 3, and in the orbit in 1 patient. On the radiographs, the lesions appeared well-circumscribed, expansile, and lytic. On CT, the lesions were predominantly multiloculated, with thin septa, a soft-tissue component, and with expansion and remodeling of the underlying bone. On MR imaging, the solid component of the lesions was isointense on T1WI and hypointense on T2WI, with heterogeneous enhancement of the solid component and rim enhancement of the locules. Fluid-fluid levels were present in 3 patients. CONCLUSIONS Giant cell granulomas commonly present as locally aggressive, expansile, multiloculated lytic lesions, with solid as well as cystic areas. The solid component is typically hypointense on T2WI. Certain key imaging features of giant cell granulomas can aid the radiologist in narrowing the differential diagnosis.
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Affiliation(s)
- R Chanda
- From the Departments of Radiodiagnosis (R.C., S.S.R., M.K., A.I.)
| | - S S Regi
- From the Departments of Radiodiagnosis (R.C., S.S.R., M.K., A.I.)
| | - M Kandagaddala
- From the Departments of Radiodiagnosis (R.C., S.S.R., M.K., A.I.)
| | - A Irodi
- From the Departments of Radiodiagnosis (R.C., S.S.R., M.K., A.I.)
| | | | - M John
- Otorhinolaryngology (M.J.), Christian Medical College, Vellore, India
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Waldman S, Shimonov M, Yang N, Spielman D, Godfrey KJ, Dean KE, Phillips CD, Helman SN. Benign bony tumors of the paranasal sinuses, orbit, and skull base. Am J Otolaryngol 2022; 43:103404. [PMID: 35246319 DOI: 10.1016/j.amjoto.2022.103404] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 02/13/2022] [Indexed: 11/15/2022]
Abstract
Benign bony tumors of the skull base and paranasal sinuses are uncommon entities, with an overall higher incidence in males. Benign bony tumors may lead to local expansion with resultant mass effect of potentially critical structures. Some benign bony tumors may undergo malignant transformation. This article reviews the presentation and management of benign bone tumors of the skull base and paranasal sinuses with special consideration to involvement of the adjacent orbit, intracranial and critical neurovascular structures. This review covers tumor incidence, location, gross and histologic appearance as well as radiographic findings, treatment, and recurrence rates. Tumors discussed in this article include osteochondromas, osteomas, osteoid osteomas, aneurysmal bone cysts, fibrous dysplasia, giant cell tumors, cemento-ossifying fibroma, ameloblastic fibro-odontoma, ecchordosis physaliphora, chondromyxoid fibroma, primary chronic osteomyelitis, primary chronic osteomyelitis, osteochondromyxoma, and dense bone islands.
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Affiliation(s)
- Spencer Waldman
- SUNY Downstate, College of Medicine, 450 Clarkson Ave, Brooklyn, NY 11203, United States of America.
| | - Menachem Shimonov
- SUNY Downstate, College of Medicine, 450 Clarkson Ave, Brooklyn, NY 11203, United States of America.
| | - Nathan Yang
- Weill Cornell Medical College, Department of Otolaryngology - Head and Neck Surgery, 2315 Broadway, 3rd Floor, New York, NY 10024, United States of America.
| | - Daniel Spielman
- Weill Cornell Medical College, Department of Otolaryngology - Head and Neck Surgery, 2315 Broadway, 3rd Floor, New York, NY 10024, United States of America.
| | - Kyle J Godfrey
- Weill Cornell Medical College, Department of Ophthalmology--1305 York Ave, 12(th) Floor New York, NY 10021, United States of America.
| | - Kathryn E Dean
- Weill Cornell Imaging at New York-Presbyterian 1305 York Avenue,3rd Floor, New York, NY 10021, United States of America.
| | - C Douglas Phillips
- Weill Cornell Imaging at New York-Presbyterian 1305 York Avenue,3rd Floor, New York, NY 10021, United States of America.
| | - Samuel Nathaniel Helman
- Weill Cornell Medical College, Department of Otolaryngology - Head and Neck Surgery, 2315 Broadway, 3rd Floor, New York, NY 10024, United States of America.
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Jain S, Thiagarajan S, Panjwani P, Sathe P, Ramadwar M. The clinical challenges and dilemma in the management of uncommon maxillary sinus tumors - A report of two cases. J Oral Maxillofac Pathol 2022; 26:S116-S118. [PMID: 35450242 PMCID: PMC9017833 DOI: 10.4103/jomfp.jomfp_236_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/24/2021] [Accepted: 11/24/2021] [Indexed: 12/30/2022] Open
Abstract
Maxillary sinus is the common site for the nose and paranasal sinus tumors with diverse histopathological types and the treatment for each may differ. Making a histopathological diagnosis on occasion can be challenging. We had two patients presenting with upper alveolus growth in whom establishing the histopathological diagnosis was challenging. Through clinical evaluation, imaging (computed tomography and/or magnetic resonance imaging) and identification of key histopathological features helped in the management of these patients.
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Affiliation(s)
- Siddhanth Jain
- Department of Head and Neck Surgical Oncology, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Shivakumar Thiagarajan
- Department of Head and Neck Surgical Oncology, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Poonam Panjwani
- Department of Pathology, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Pranav Sathe
- Department of Head and Neck Surgical Oncology, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Mukta Ramadwar
- Department of Pathology, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Sepulveda I, Alzerreca J, Villalobos P, Ulloa JP. Giant Cell Tumor of the Temporal Bone With Skull Base and Middle Ear Extension. J Med Cases 2021; 12:149-151. [PMID: 34434449 PMCID: PMC8383659 DOI: 10.14740/jmc3627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/31/2020] [Indexed: 12/14/2022] Open
Abstract
We report on a patient who presented to the ear, nose, and throat (ENT) clinic with an 8-month-old left non-pulsatile tinnitus. Imaging studies, Neck computed tomography (CT) and magnetic resonance imaging (MRI) revealed soft tissue mass in the left middle ear with invasion to the middle cranial fossa and external auditory canal.
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Affiliation(s)
- Ilson Sepulveda
- Finis Terrae University School of Dentistry, Radiology Department ENT-Head and Neck Surgery, Maxilofacial and Nuclear Medicine Services, General Hospital of Concepcion, San Martin Av. 1436, Concepcion, Chile
| | - Jose Alzerreca
- ENT Department, Clinic of De los Andes University, Santiago, Chile
| | - Pamela Villalobos
- Pathology Department, University of Concepcion School of Medicine, Concepcion, Chile
| | - J Patricio Ulloa
- Department ENT-Head and Neck Surgery, General Hospital of Concepcion, University of Concepcion School of Medicine, Concepcion, Chile
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Weng JC, Li D, Wang L, Wu Z, Wang JM, Li GL, Jia W, Zhang LW, Zhang JT. Surgical management and long-term outcomes of intracranial giant cell tumors: a single-institution experience with a systematic review. J Neurosurg 2019; 131:695-705. [PMID: 30497189 DOI: 10.3171/2018.4.jns1849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/23/2018] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Intracranial giant cell tumors (GCTs) are extremely rare neoplasms with dismal survival and recurrence rates. The authors aimed to confirm independent adverse factors for progression-free survival (PFS) and to propose an optimal treatment algorithm. METHODS The authors reviewed the clinical data of 43 cases of intracranial GCTs in their series. They also reviewed 90 cases of previously reported GCTs in the English language between 1982 and 2017 using Ovid MEDLINE, Embase, PubMed, and Cochrane databases with keywords of "giant cell tumor" or "osteoclastoma" and "skull," "skull base," "temporal," "frontal," "sphenoid," or "occipital." These prior publication data were processed and used according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Aforementioned risk factors for the authors' series and the pooled cases were evaluated in patients not lost to follow-up (m = 38 and n = 128, respectively). RESULTS The authors' cohort included 28 males and 15 females with a mean age of 30.5 years. Gross-total resection (GTR) was achieved in 15 (34.9%) patients. Fifteen patients (39.5%) who did not undergo GTR received postoperative radiotherapy with a mean total dose of 54.7 ± 4.1 Gy. After a mean follow-up of 71.3 months, 12 (31.6%) patients experienced recurrence, and 4 (10.5%) died of disease. The actuarial 5-year PFS and overall survival (OS) were 68.6% and 90.0% in the authors' cohort, respectively. A multivariate Cox regression analysis verified that partial resection (HR 7.909, 95% CI 2.296-27.247, p = 0.001), no radiotherapy (HR 0.114, 95% CI 0.023-0.568, p = 0.008), and Ki-67 ≥ 10% (HR 7.816, 95% CI 1.584-38.575, p = 0.012) were independent adverse factors for PFS. Among the 90 cases in the literature, GTR was achieved in 49 (54.4%) cases. Radiotherapy was administered to 33 (36.7%) patients with a mean total dose of 47.1 ± 5.6 Gy. After a mean follow-up of 31.5 months, recurrence and death occurred in 17 (18.9%) and 5 (5.6%) cases, respectively. Among the pooled cases, the 5-year PFS and OS were 69.6% and 89.2%, respectively. A multivariate model demonstrated that partial resection (HR 4.792, 95% CI 2.909-7.893, p < 0.001) and no radiotherapy (HR 0.165, 95% CI 0.065-0.423, p < 0.001) were independent adverse factors for poor PFS. CONCLUSIONS GTR and radiotherapy were independent favorable factors for PFS of intracranial GCTs. Based on these findings, GTR alone or GTR plus radiotherapy was advocated as an optimal treatment; otherwise, partial resection plus radiotherapy with a dose ≥ 45 Gy, if tolerable, was a secondary alternative. Lack of randomized data of the study was stressed, and future studies with larger cohorts are necessary to verify these findings.Systematic review no.: CRD42018090878 (crd.york.ac.uk/PROSPERO/).
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Affiliation(s)
- Jian-Cong Weng
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
| | - Da Li
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
| | - Liang Wang
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
| | - Zhen Wu
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
| | - Jun-Mei Wang
- 2Department of Neuropathology, Beijing Neurosurgical Institute, Beijing, People's Republic of China
| | - Gui-Lin Li
- 2Department of Neuropathology, Beijing Neurosurgical Institute, Beijing, People's Republic of China
| | - Wang Jia
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
| | - Li-Wei Zhang
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
| | - Jun-Ting Zhang
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
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Whyte MP, Madson KL, Mumm S, McAlister WH, Novack DV, Blair JC, Helliwell TR, Stolina M, Abernethy LJ, Shaw NJ. Rapid skeletal turnover in a radiographic mimic of osteopetrosis. J Bone Miner Res 2014; 29:2601-9. [PMID: 24919763 PMCID: PMC4391634 DOI: 10.1002/jbmr.2289] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 04/30/2014] [Accepted: 05/26/2014] [Indexed: 12/13/2022]
Abstract
Among the high bone mass disorders, the osteopetroses reflect osteoclast failure that prevents skeletal resorption and turnover, leading to reduced bone growth and modeling and characteristic histopathological and radiographic findings. We report an 11-year-old boy with a new syndrome that radiographically mimics osteopetrosis (OPT), but features rapid skeletal turnover. He presented at age 21 months with a parasellar, osteoclast-rich giant cell granuloma. Radiographs showed a dense skull, generalized osteosclerosis and cortical thickening, medullary cavity narrowing, and diminished modeling of tubular bones. His serum alkaline phosphatase was >5000 IU/L (normal <850 IU/L). After partial resection, the granuloma re-grew but then regressed and stabilized during 3 years of uncomplicated pamidronate treatment. His hyperphosphatasemia transiently diminished, but all bone turnover markers, especially those of apposition, remained elevated. Two years after pamidronate therapy stopped, bone mineral density (BMD) Z-scores reached +9.1 and +5.8 in the lumbar spine and hip, respectively, and iliac crest histopathology confirmed rapid bone remodeling. Serum multiplex biomarker profiling was striking for low sclerostin. Mutation analysis was negative for activation of lipoprotein receptor-related protein 4 (LRP4), LRP5, or TGFβ1, and for defective sclerostin (SOST), osteoprotegerin (OPG), RANKL, RANK, SQSTM1, or sFRP1. Microarray showed no notable copy number variation. Studies of his nonconsanguineous parents were unremarkable. The etiology and pathogenesis of this unique syndrome are unknown.
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Affiliation(s)
- Michael P. Whyte
- Center for Metabolic Bone Disease and Molecular Research, Shriners Hospital for Children; St. Louis, MO, USA, 63131
- Division of Bone and Mineral Diseases, Washington University School of Medicine at Barnes-Jewish Hospital; St. Louis, MO, USA, 63110
| | - Katherine L. Madson
- Center for Metabolic Bone Disease and Molecular Research, Shriners Hospital for Children; St. Louis, MO, USA, 63131
| | - Steven Mumm
- Center for Metabolic Bone Disease and Molecular Research, Shriners Hospital for Children; St. Louis, MO, USA, 63131
- Division of Bone and Mineral Diseases, Washington University School of Medicine at Barnes-Jewish Hospital; St. Louis, MO, USA, 63110
| | - William H. McAlister
- Department of Pediatric Radiology, Mallinckrodt Institute of Radiology at St. Louis Children’s Hospital, Washington University School of Medicine; St. Louis, MO, USA, 63110
| | - Deborah V. Novack
- Division of Bone and Mineral Diseases, Washington University School of Medicine at Barnes-Jewish Hospital; St. Louis, MO, USA, 63110
- Department of Pathology, Washington University School of Medicine at Barnes-Jewish Hospital; St. Louis, MO, USA, 63110
| | - Jo C. Blair
- Department of Endocrinology, Alder Hey Children’s National Health Service Foundation Trust; Liverpool, UK, L12 2AP
| | - Timothy R. Helliwell
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool; Liverpool, UK, L69 3GA
| | | | - Laurence J. Abernethy
- Department of Radiology, Alder Hey Children’s National Health Service Foundation Trust; Liverpool, UK, L12 2AP
| | - Nicholas J. Shaw
- Department of Endocrinology and Diabetes, Birmingham Children’s Hospital; Birmingham, UK, B4 6NH
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