Giant Cell Tumor of the Temporal Bone and Skull Base: A Case Report

[Simultaneous occurrence of facial neurinoma in internal auditory canal and middle ear paraganglioma in patient. Unusual combination and difficult surgical task]

CLINICAL CASE

The 59-year-old patient complained of hearing loss on the left, ear murmur for a long time, periodic pain and discomfort in the left ear, dizziness for 6 months. She was found to have concurrent vestibular schwannoma in the internal auditory canal and temporal bone paraganglioma. Both tumors were removed in one operation. The schwannoma was removed by translabirinth access due to preoperative deafness, while the glomus tumor was removed during this access. Postoperative biopsy showed the presence of two unrelated diseases: paraganglioma (ICD-0 code 8690/3) and schwannoma (ICD-0 code 9560/0).

Giant Cell Tumor of the Temporal Bone and Skull Base

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.

Case report: Langerhans cell histiocytosis of the temporal bone in children: Challenging diagnosis of a rare disease with some pitfalls

A 4‐year‐old girl was admitted to hospital with disturbance of balance. After being questioned, parents remembered an otitis with effusion 3 months earlier. CT‐scans revealed destruction of both temporal bones. Initial biopsy showed granulomatous, necrotic inflammation, which led to comprehensive differential diagnoses. A second tissue sample confirmed Langerhans cell histiocytosis.

Surgical management of giant cell tumor invading the occipital bone: A case report and literature review

Background:

Giant cell tumor of bone (GCTB) rarely originates in the skull, particularly in the occipital bone. Although benign, it can severely destroy the surrounding tissue and undergo an unpredictable clinical course. We report the successful resection of a GCTB invading the occipital bone in a Hispanic adult woman and present a comprehensive review of the literature on this rare pathology by focusing on the occipital area.

Case Description:

A 40-year-old Hispanic woman presented with a 3-month history of neck pain and a bulging lesion on the retromastoid area. Brain magnetic resonance imaging (MRI) revealed an extradural, expansive, and contrast-enhancing lesion in the right occipital bone with multiple thin septa and evidence of bleeding. The patient underwent an uneventful gross total resection (GTR) of the lesion. The histopathological examination findings included numerous scattered osteoclast-type giant multinucleated cells. At a 10-month follow-up, the patient has not developed any neurological deficits, impairment of life functioning, or signs of recurrence in MRI.

Conclusion:

GCTB rarely originates in the skull, being the occipital bone the most infrequent site of presentation. When feasible, total surgical resection effectively reduces the risk of recurrence. Nonetheless, radiation and adjuvant therapies have been employed when GTR could not be achieved. A close follow-up with a brain MRI is advised to control recurrence.

Giant Cell Tumor of the Temporal Bone With Skull Base and Middle Ear Extension

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.

A single-center experience with giant cell tumors of sphenoid bone and clivus

OBJECTIVE

To present pathologic, clinical, and treatment findings for giant cell tumors (GCTs) of sphenoid bone and clivus.

METHODS

We describe the optimal treatment algorithm in patients with a histopathologic diagnosis of bone GCT by presenting the effects of denosumab treatment in both pediatric and adult patients with GCT undergoing endoscopic transnasal surgery. Clinicopathologic correlation is crucial for the differential diagnosis of GCT and the choice of treatment modality.

CONCLUSION

GCT of bone is a local aggressive tumor that accounts for about 3%-7% of all bone tumors. GCTs located in the cranium are extremely uncommon neoplasms. There are no defined guidelines for the treatment of GCTs in skull base. Following surgical resection of the tumor, the addition of denosumab treatments to radiotherapy has a significant role in preventing the recurrence of GCT and in promoting regression of residual tumor size.

Diffuse Tenosynovial Giant Cell Tumor Around the Temporomandibular Joint: An Entity With Special Radiologic and Pathologic Features

PURPOSE

Diffuse tenosynovial giant cell tumor (TGCT) of the temporomandibular joint (TMJ) is rare. The aim of the present study was to summarize the clinical, radiologic, and pathologic features of this tumor.

MATERIALS AND METHODS

Nine cases of TGCT in the TMJ region were examined. All available radiologic and pathologic documents were carefully reviewed. These cases were grouped into 3 types according to the radiologic features: bone-centered type, intraosseous type, and soft tissue type. Cases reported in the literature were reviewed to better summarize the clinical characteristics.

RESULTS

TGCTs in the TMJ region showed some special radiologic and pathologic features. Radiologically, the lesion could be centered in the craniofacial bone or centered in the surrounding soft tissue. Four cases were categorized as the bone-centered type, 1 was categorized as the intraosseous type, and 4 were categorized as the soft tissue type. Pathologically, epithelioid mononuclear cells with abundant eosinophilic cytoplasm and eccentric nuclei were observed in all cases. Chondroid metaplasia was noted in 8 cases. Some areas were similar to giant cell reparative granuloma and chondroblastoma. All patients who underwent complete tumor resection showed no evidence of recurrence at follow-up. Of the 93 reported cases, only 5 developed postoperative recurrence and distant metastasis.

CONCLUSION

TGCTs of the TMJ region share similar radiologic and pathologic features as other tumors, which indicates the TGCT might be a special entity within a spectrum of diseases.