Giant cell tumor of the temporal bone--a case report

Mammoth Giant Cell Tumor of the First Metacarpal: A Case Report and Management Trends

Giant cell tumor (GCT) is classically described as a locally aggressive, epiphyseo-metaphyseal osteolytic tumor occurring in young adults. They are mostly seen in long bones while some are also found in the iliac bone and spine and a very small proportion occurs in hand bones. Due to the rarity of GCT in metacarpal, there is a paucity of treatment options available. In an extensive literature search on PubMed, Embase, Medline, and Ovid from 2004 till date, very few cases were reported.

The various treatment options available are intralesional curettage with or without adjuvant therapy, wide resection, free osteoarticular metatarsal transfer, and, occasionally, ray amputation may also be done. After simple curettage, a reasonably high recurrence rate also imposes comprehensive en-bloc excision, but still, there are many case reports of recurrence.

Experience with a case of GCT of the whole first metacarpal extending from the carpometacarpal to the metacarpophalangeal joint is not thoroughly described in the literature. We hereby report a mammoth GCT of the first metacarpal treated by excision and reconstruction by free fibular graft and adjacent joint fusion with an excellent functional outcome at one-year follow-up.

Intracranial giant cell tumour—a case report

Background

Giant cell tumours (GCT) are rare benign bone tumours that typically occur in the appendicular skeleton. In typical locations, these tumours are relatively simple to diagnose by radiography. However, at atypical locations, these tumours can be confused with other disease pathologies. Here, we describe a patient with an intracranial GCT that was initially thought to be a cystic teratoma.

Case presentation

A 49-year-old man with no previous medical illness was investigated for left-sided hearing impairment and tinnitus associated with a left-sided headache of 2 years’ duration. He did not complain of fever, vertigo, nasal or constitutional symptoms. Examination confirmed a sensory neural hearing loss with no other neurological deficit. Imaging by CT and subsequent MRI revealed an extra axial, multiloculated, and septated mass at the left temporal area with a significant mass effect. A provisional diagnosis of cystic teratoma was made. However, histopathological examination of the resected mass indicated that the lesion was a GCT. The patient required a second excision of the tumour, which he refused. His latest follow-up MRI showed no further progression of the residual tumour. His headaches have resolved and there was no progression of other symptoms.

Conclusion

This case highlights that GCTs can occur at sites outside the appendicular skeleton and that these tumours may be confused with other diseases that have a similar appearance on imaging.

Disease classification via gene network integrating modules and pathways

Disease classification based on gene information has been of significance as the foundation for achieving precision medicine. Previous works focus on classifying diseases according to the gene expression data of patient samples, and constructing disease network based on the overlap of disease genes, as many genes have been confirmed to be associated with diseases. In this work, the effects of diseases on human biological functions are assessed from the perspective of gene network modules and pathways, and the distances between diseases are defined to carry out the classification models. In total, 1728 diseases are divided into 12 and 14 categories by the intensity and scope of effects on pathways, respectively. Each category is a mix of several types of diseases identified based on congenital and acquired factors as well as diseased tissues and organs. The disease classification models on the basis of gene network are parallel with traditional pathology classification based on anatomic and clinical manifestations, and enable us to look at diseases in the viewpoint of commonalities in etiology and pathology. Our models provide a foundation for exploring combination therapy of diseases, which in turn may inform strategies for future gene-targeted therapy.

A Rare Case Report of Giant Cell Tumor of the Sphenoid Bone in a Patient Who Developed "Erythema Multiforme Associated with Phenytoin and Cranial Radiation Therapy Syndrome"

Giant cell tumors (GCTs) are rare, usually affecting the epiphyses in long bones of the extremities. GCTs may be locally aggressive with a high rate of local recurrence and exhibit the potential for distant metastasis. They seldom occur in the skull, where they preferentially affect the sphenoid and temporal bones. Several case reports with follow-up describe gross total resection of skull-base GCT to be curative. Radiation therapy, although controversial, is reserved for lesions that cannot be completely resected. Here, we describe the case of an 18-year-old female with GCT of sphenoid bone who underwent subtotal resection followed by adjuvant radiotherapy, although whose radiotherapy could not be completed because of her demise due to erythema multiforme associated with phenytoin and cranial radiation therapy syndrome.

Giant Cell Tumor of the Lateral Skull Base: Diagnostic and Management Options

Giant cell tumor of bone (GCTB) is a rare, benign, osteolytic neoplasm that most commonly occurs in early adulthood and often involves the long bones of the body. Although GCTB largely affects the epiphyses of long bones, several reports of GCTB involvement of the cranial and facial bones exist in the literature. In addition to reviewing other reported cases of GCTBs of the lateral skull base in the literature, the authors report here on the clinical presentation, radiographic findings, and neurosurgical management of a patient found to have a GCTB of the middle and infratemporal fossae, which was treated by aggressive en bloc resection of the lateral skull base.

En-bloc Resection of a Giant Cell Tumor Causing Cervical Vertebral Collapse

Giant cell tumors (GCTs) are rare, benign, and locally aggressive primary bone neoplasms. Spine is seldom affected, especially above the level of sacrum. In this report, we describe a case with GCT of the cervical vertebrae which causes collapse of the corpus. A 32-year-old female presented with gradual neck pain and abrupt paresthesia of the left hand. Computed tomography scan showed C6 vertebral collapse and magnetic resonance imaging demonstrated vertebral plana of C6 by a low signal intensity lesion on T1- and T2-weighted images. Emergent surgical intervention was taken due to the possibility of spinal injury. The tumor was removed by en-bloc resection and histopathological investigation confirmed GCT. In most of the cases, en-bloc resection of GCTs of the spine is not feasible. Despite the location and close contact of the lesion with spinal cord, later approach was successful for our case; thus, appropriate differential diagnosis for vertebral column lesions as well as selecting an optimum treatment is mandatory.

Giant Cell Tumor of the Frontal Bone Presenting as an Orbital Mass

A 10-year-old male was referred for evaluation of a right orbital mass present for 3 weeks with associated tenderness to palpation. Magnetic resonance imaging (MRI) and computed tomography imaging (CT) revealed a solid mass centered in the frontal bone with extension into the orbit. Surgical excision and histologic analysis of the lesion was consistent with a diagnosis of a Giant Cell Tumor (GCT) of the frontal bone. The patient tolerated the procedure without complication and is doing well upon follow-up.

Recurrent Giant Cell Tumor of Skull Combined with Multiple Aneurysms

Giant cell tumors are benign but locally invasive and frequently recur. Giant cell tumors of the skull are extremely rare. A patient underwent a surgery to remove a tumor, but the tumor recurred. Additionally, the patient developed multiple aneurysms. The patient underwent total tumor resection and trapping for the aneurysms, followed by radiotherapy. We report this rare case and suggest some possibilities for treating tumor growth combined with aneurysm development.

Rare Presentation of Giant Cell Tumor in the Internal Auditory Canal: Case Report and Review of the Literature

Giant cell tumor (GCT) is a benign but locally aggressive bone tumor that usually involves the end of long bones. It is a relatively common neoplasm in patients, constituting 5 to 10% of all benign bone tumors. Approximately 2% of GCTs occur in the craniofacial skeleton with a predilection for the ethmoid, sphenoid, and temporal bones. The skull base location is unique and not commonly described. Hearing loss, headache, tinnitus, and subcutaneous masses are the most commonly reported symptoms in GCTs of the skull base. In this case report we present the first description of a GCT within the internal auditory canal causing cranial neuropathy and review the recent pertinent literature.

Giant cell tumor of the clivus: A case report and review of the literature

Giant cell tumors (GCTs) mainly occur in metaphyses of long bones and are generally considered histologically benign; however, GCTs may be locally aggressive with a high rate of local recurrence and exhibit the potential for distant metastasis. Primary GCT of the clivus is extremely rare and is easily misdiagnosed and, thus, treatment remains controversial. The present report describes the case of a 22-year-old male with GCT located in the skull base originating from the clivus, with the involvement of multiple cranial nerves, which was successfully treated with transnasal transsphenoidal surgery following adjuvant radiotherapy and intravenous bisphosphonate administration. The patient remains symptom free at two years of follow-up. This report contributes to the limited literature regarding GCTs of the skull.

Giant cell tumor of the clivus with presence of epithelioid histiocytes

Giant cell tumor (GCT) is a benign neoplasm but locally aggressive tumor that uncommonly involves the skull bone. We report a case of a 62-year-old male presented with increasing headache and diplopia. Investigations were suggestive of an expanding mass lesion of the clivus. Histopathology was suggestive of diagnosed with GCT with abundant histiocytes.

Giant cell tumor of the frontal bone in a girl: case report

A 2-year-old female presented with a rare case of recurrent giant cell tumor affecting the frontal bone. She had already undergone partial removal twice at the ages of 14 and 18 months. The tumor was located in the frontal bone, expanding to the ethmoid and orbital bones, and invading the frontal base dura mater. The tumor was totally removed including the surrounding bone and frontal base dura mater. No local recurrence and metastasis were observed at 18 months after the last operation. Most giant cell tumors occur in the epiphyses of long bones and are rare in the cranio-facial bone. These tumors usually affect young adults and few pediatric cases are reported.

A swollen middle finger in a middle-aged farmer

Hand tumors are not common and a swollen finger poses considerable diagnostic dilemma. We present a case of a middle-aged farmer who had presented with a painless swelling of the middle finger of the right hand without any neurovascular deficit or evidence of metastasis. An X-ray of the finger showed cortical expansion and bony erosion of the proximal phalanx. A fine needle aspiration cytological examination was inconclusive. He underwent a digit amputation in view of subsequent morbidity and chances of recurrence following local excision. Biopsy proved it to be a giant cell tumor of the proximal phalanx. Following six months of treatment he is doing well. We herein highlight an unusual tumor of the finger and its diagnostic and treatment challenges.

Giant cell tumour of the posterior cranial fossa: a case report

Giant cell tumours (GCTs) of the cranium preferentially affect the sphenoid and temporal bones. We report a 19-year-old patient with GCT involving the left occipital bone and petromastoid portion of the temporal bone. CT and MRI revealed a predominantly expansive soft-tissue mass of the posterior cranial fossa. The patient underwent surgery. Permanent histopathological sections and immunostatins revealed the presence of a GCT. The radiological features and method of surgical intervention of this rare lesion are discussed.

Extracranial meningioma in the vicinity of the temporal bone: a difficult preoperative diagnosis

BACKGROUND

Extracranial meningioma is a rare tumor, and most of the time only after histopathologic examination is diagnosis possible.

CASE DESCRIPTION

A 40-year-old right-handed woman presented with progressive swelling over the right side of the forehead and temporal region associated with proptosis and visual loss. Incisional biopsy of the lesion was reported as spindle cell tumor. Computed tomography scan showed large enhancing predominantly extracranial lesion located in the right anterior frontotemporal region extending into the infratemporal fossa and a relatively thin sheet of tumor on the intracranial aspect of the thickened temporal. Intraoperative impression was malignant tumor involving the temporalis muscle, and a near total excision of the lesion was performed. Histopathologic features were suggestive of meningothelial meningioma arising from the temporal bone with predominant extracranial extension.

CONCLUSION

Preoperative suspicion of a meningioma in this patient would have resulted in a more aggressive surgical approach as these lesions are relatively benign with indolent course.