giant cell tumor of bone (osteoclastoma)
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Epidemiology
- relatively uncommon
- 4-5% of primary bone tumors
- ~20% of benign bone tumors
- higher incidence in Asia
Pathology
- multinucleated giant cells (osteoclasts or osteoclast-like)
- generally benign
- giant cell tumour stromal cells of osteoblastic origin constitute the neoplastic cells
- multinucleated giant cells (osteoclasts) are secondarily recruited & along with mononuclear histiocytic cells comprise the non-neoplastic cell population
Radiology
chest X-ray or CT of thorax to assess metastasis
MRI useful to evaluae intramedually & soft-tissue extension
Complications
- pathologic fracture
- metastasis (5%) usually to lung
Differential diagnosis
- osteosarcoma
- chondroblastoma
- osteoid osteoma
- osteoblastoma
- bone cyst
- brown tumor of hyperparathyroidism
Management
- surgery if tumor is resectable
- curettage is most common technique
- zoledronate is thought to induce osteoclast apoptosis, preventing tumor-induced osteolysis
- Denosumab targeting the RANK ligand (RANKL) is experimental
More general terms
References
- ↑ Wikipedia: giant cell tumor of bone http://en.wikipedia.org/wiki/Giant_cell_tumor_of_bone
- ↑ Klenke FM et al Giant Cell Tumor of Bone: Risk Factors for Recurrence. Clin Orthop Relat Res. 2010 Aug 13. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20706812
- ↑ Karpik M. Giant Cell Tumor (tumor gigantocellularis, osteoclastoma)
epidemiology, diagnosis, treatment. Ortop Traumatol Rehabil. 2010 May-Jun;12(3):207-15. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20675862 - ↑ Thomas DM, Skubitz KM. Giant cell tumour of bone. Curr Opin Oncol. 2009 Jul;21(4):338-44. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19444102
- ↑ Pathology outlines http://pathologyoutlines.com/bone.html#giantcelltumor
Patient information
giant cell tumor of bone (osteoclastoma) patient information