Giant Cell Tumor

Question 1

What location in bones are giant cell tumors typically found?

Answer 1

Epiphysis
50% occur around the knee, 10% in the axial skeleton (sacrum is most common); distal radius is third most common location

Question 2

Where do giant cell tumors commonly metastasize?

Answer 2

Giant cell tumors are benign but 2-5% metastasize to lung

Hand lesions more commonly metastasize; radiation can lead to malignant transformation 15% of the time

Question 3

What ist he imaging and histologic appearance of giant cell tumor?

Answer 3

Eccentric lytic lesion in epiphysis/metaphysis that borders subchondral bone; MRI T1 shows demarcation between lesion and fat marrow; histology shows abundant giant cells

Question 4

What medical management can reduce size of giant cell tumor?

Answer 4

bisphosphonates; denosumab (monoclonal Ab against RANKL)

Question 5

How are giant cell tumors typically treated?

Answer 5

Extensive curettage, adjuvant treatment (phenol, argon beam, hydrogen peroxide), and cement; hand lesions are curettage v amputation (if has cortical breakthrough)