Clinical Scenario and Imaging with Illustrations of Giant Cell Tumor of Bone: A Retrospective Analysis

Background: The giant cell tumour of the bone has a spectrum of clinical-radiological presentation. This study aims to describe this varied presentation in our institution. Methods: This retrospective study was conducted on twenty-nine pathologically labelled cases of giant cell tumours of the bone. The medical records for their clinical presentation and diagnostic imaging studies were studied and evaluated. Results: Mean age of the patients at presentation was ۳۵.۳±۱۲.۹ years. Pain, local swelling and restricted joint function were seen in ۹۳ %, ۵۸.۶ % and ۵۲ % patients, respectively. The cortical breach was seen in ۱۵ (۵۱.۷ %) and ۲۲ (۷۵.۹ %) lesions on plain radiographs and CT images, respectively. ۱۴(۴۸.۳ %) cases had soft tissue invasion on MRI at presentation. ۲۶ (۸۹.۷ %) lesions were located within ۱ cm from the articular cartilage. The solid tumour component was hypo to iso-intense in signal intensity in ۲۷ (۹۳.۱ %) lesions in T۱ weighted and ۲۱ (۷۲.۴ %) in T۲ weighted images. ۱۴ (۴۸.۳ %) had hyperintense cystic areas, and fluid-fluid levels, suggestive of aneurysmal bone cysts, were seen in ۴ (۱۳.۸ %) cases on T۲ weighted images. Hypo-echoic nodular areas in solid tumour component, suggestive of hemosiderin deposits, were present in ۳ (۱۰.۳ %) lesions on T۱ and T۲ weighted images. Conclusion: The tumour classically presents as an epiphysial-metaphyseal, eccentric, expansile, lytic lesion in a skeletally mature patient. The MRI picture is variable and the surgeon should have a sound knowledge of these variations to obtain a biopsy sample from a proper site of the lesion and to avoid misdiagnosis especially of a primary ABC. Level of evidence: IV

Keywords:

giant-cell , ABCGiant-Cell , soap-bubble , hemosiderin , fluid-fluid , ABC