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Giant cell tumor

Etiology: • Not known.

Pathogenesis: • Unknown.

Epidemiology: • Usually arise in the third to the fifth decade of life. • Slightly more common in females.

General Gross Description: • Giant Cell Tumor of Bone: Also called Osteoclastoma • Tumors are usually large and distinctly red colored. • Areas of hemorrhage and cystic degeneration are frequent.

General Microscopic Description: • Histologically, the tumor is composed of mononuclear cells and many multinucleate cells, often with 40 to 100 nucleii. • The nucleii of the mononuclear cells and the giant cells are identical. • This is an important distinguishing feature of this tumor from other giant cell containing tumors and other lesions of bone, such as pigmented villonodular synovitis, or hyperparathyroidism. • There is often evidence of recent and old hemorrhage (indicated by hemosiderin deposits). • Some reparative bone formation can be seen in older lesions.

Clinical Correlations: • Locally aggressive tumor; usually does not metastasize distally. • Tumors are most common around the knee joint, but any other bone may be involved. • Symptoms are usually related to the involvement of the joint, including pain and restriction of movement. • Occassionally, the patient may present with a fracture. • X-ray examination of affected bone shows a clear lytic lesion that often erodes through the cortical bone into the neighboring soft tissue. • There is usually no sclerotic rim around the tumor. • The tumor has a tendency to local recurrence after conservative treatment.

References: •Robbins "Pathologic Basis of Disease". (Cotran, Kumar and Robbins, Eds.) 5th Edition. pp 1245.