BACKGROUND For patients with acute paraplegia caused by spinal giant cell tumor(GCT)who require emergency decompressive surgery,there is still a lack of relevant reports on surgical options.This study is the first to ...BACKGROUND For patients with acute paraplegia caused by spinal giant cell tumor(GCT)who require emergency decompressive surgery,there is still a lack of relevant reports on surgical options.This study is the first to present the case of an acute paraplegic patient with a thoracic spinal GCT who underwent an emergency total en bloc spondylectomy(TES).Despite tumor recurrence,three-level TES was repeated after denosumab therapy.CASE SUMMARY A 27-year-old female patient who underwent single-level TES in an emergency presented with sudden severe back pain and acute paraplegia due to a thoracic spinal tumor.After emergency TES,the patient's spinal cord function recovered,and permanent paralysis was avoided.The postoperative histopathological examination revealed that the excised neoplasm was a rare GCT.Unfortunately,the tumor recurred 9 months after the first surgery.After 12 months of denosumab therapy,the tumor size was reduced,and tumor calcification.To prevent recurrent tumor progression and provide a possible cure,a three-level TES was performed again.The patient returned to an active lifestyle 1 month after the second surgery,and no recurrence of GCT was found at the last follow-up.CONCLUSION This patient with acute paraplegia underwent TES twice,including once in an emergency,and achieved good therapeutic results.TES in emergency surgery is feasible and safe when conditions permit;however,it may increase the risk of tumor recurrence.展开更多
BACKGROUND Giant cell tumor of bone is a locally aggressive and rarely metastasizing tumor,and also a potential malignant tumor that may develop into a primary malignant giant cell tumor.AIM To evaluate the role of mu...BACKGROUND Giant cell tumor of bone is a locally aggressive and rarely metastasizing tumor,and also a potential malignant tumor that may develop into a primary malignant giant cell tumor.AIM To evaluate the role of multimodal imaging in the diagnosis of giant cell tumors of bone.METHODS The data of 32 patients with giant cell tumor of bone confirmed by core-needle biopsy or surgical pathology at our hospital between March 2018 and March 2023 were retrospectively selected.All the patients with giant cell tumors of the bone were examined by X-ray,computed tomography(CT)and magnetic resonance imaging(MRI),and 7 of them were examined by positron emission tomography(PET)-CT.RESULTS X-ray imaging can provide overall information on giant cell tumor lesions.CT and MRI can reveal the characteristics of the internal structure of the tumor as well as the adjacent relationships of the tumor,and these methods have unique advantages for diagnosing tumors and determining the scope of surgery.PET-CT can detect small lesions and is highly valuable for identifying benign and malignant tumors to aid in the early diagnosis of metastasis.CONCLUSION Multimodal imaging plays an important role in the diagnosis of giant cell tumor of bone and can provide a reference for the treatment of giant cell tumors.展开更多
BACKGROUND Invasive breast carcinoma with osteoclast-like stromal giant cells(OGCs) is an extremely rare morphology of breast carcinomas.To the best of our knowledge,the most recent case report describing this rare pa...BACKGROUND Invasive breast carcinoma with osteoclast-like stromal giant cells(OGCs) is an extremely rare morphology of breast carcinomas.To the best of our knowledge,the most recent case report describing this rare pathology was published six years ago.The mechanism controlling the development of this unique histological formation is still unknown.Further,the prognosis of patients with OGC involvement is also controversial.CASE SUMMARY We report the case of a 48-year-old woman,who presented to the outpatient department with a palpable,growing,painless mass in her left breast for about one year.Sonography and mammography revealed a 26.5 mm ×18.8 mm asymmetric,lobular mass with circumscribed margin and the Breast Imaging Reporting and Data System was category 4C.Sono-guided aspiration biopsy revealed invasive ductal carcinoma.The patient underwent breast conserving surgery and was diagnosed with invasive breast carcinoma with OGCs,grade Ⅱ,with intermediate grade of ductal carcinoma in situ(ER:80%,3+,PR:80%,3+,HER-2:negative,Ki 67:30%).Adjuvant chemotherapy and post-operation radiotherapy were initiated thereafter.CONCLUSION As a rare morphology of breast cancer,breast carcinoma with OGC occurs most often in relatively young women,has less lymph node involvement,and its occurrence is not racedependent.展开更多
BACKGROUND Aggressive giant cell tumor of the distal fibula is so rare that no consensus on a surgical strategy has been reached.Thus,an appropriate treatment strategy is still important to discuss.CASE SUMMARY A 61-y...BACKGROUND Aggressive giant cell tumor of the distal fibula is so rare that no consensus on a surgical strategy has been reached.Thus,an appropriate treatment strategy is still important to discuss.CASE SUMMARY A 61-year-old man who had been experiencing progressive swelling of the left lateral malleolus accompanied by pain for half a year was presented at our hospital.He had never been treated prior to coming to our hospital.Preoperative imaging revealed a 10 cm×6 cm mass located in the body of the distal fibula.Pathological biopsies confirmed it was a giant cell tumor.Preoperative examination revealed he had dilated cardiomyopathy with class 3 cardiac function.The cardiologist and anesthesiologist determined that he could tolerate the operation,but the operation should be as short and minimally invasive as possible.With the patient’s consent,we performed a tibiotalar fusion and followed up with him for 2years,finding no recurrence and a satisfactory recovery.CONCLUSION Tibial talus fusion is an effective method for the treatment of distal fibula tumors.展开更多
BACKGROUND Multinucleated giant cells(MGCs)in bladder carcinomas are poorly studied.AIM To describe the function,morphogenesis,and origin of mononuclear and MGCs in urothelial carcinoma(UC)of the bladder in Bulgarian ...BACKGROUND Multinucleated giant cells(MGCs)in bladder carcinomas are poorly studied.AIM To describe the function,morphogenesis,and origin of mononuclear and MGCs in urothelial carcinoma(UC)of the bladder in Bulgarian and French patients.METHODS Urothelial bladder carcinomas(n=104)from 2016-2020 were analyzed retrospectively using immunohistochemical(IHC)and histochemical stain examination.Giant cells in the bladder stroma were found in 35.6%of cases,more often in highgrades.RESULTS We confirm that MGCs in the mucosa in UC of the bladder were positive for both mesenchymal and myofibroblast markers(vimentin,smooth muscle actin,Desmin,and CD34)and the macrophage marker CD68.Furthermore,IHC studies revealed the following profile of these cells:Positive for p16;negative for epithelial(CK AE1/AE3 and GATA-3),vascular(CD31),neural(PS100 and CKIT),cambial,blastic(CD34-blasts and C-KIT),and immune markers(IG G,immunoglobulin G4,and PD-L1);no proliferative activity,possess no specific immune function,and cannot be used to calculate the Combined Positive Score scale.CONCLUSION In conclusion,the giant stromal cells in non-tumor and tumor bladder can be used as a characteristic and relatively constant,although nonspecific,histological marker for chronic bladder damage,reflecting the chronic irritation or inflammation.Likewise,according to the morphological and IHC of the mono-and multinucleated giant cells in the bladder,they are most likely represent telocytes capable of adapting their morphology to the pathology of the organ.展开更多
BACKGROUND Giant cell-rich osteosarcoma(GCRO) is a rare histological variant of osteosarcoma. Spinal GCROs are extremely rare, with challenging diagnosis and management. Herein, we present a case of spinal GCRO at T2,...BACKGROUND Giant cell-rich osteosarcoma(GCRO) is a rare histological variant of osteosarcoma. Spinal GCROs are extremely rare, with challenging diagnosis and management. Herein, we present a case of spinal GCRO at T2, which was not diagnosed in initial biopsy but after T2 corpectomy. We detailed the clinical course, management strategy, and outcome after a 4-year follow-up.CASE SUMMARY A 17-year-old female patient presented with back pain followed by ascending paresthesia. Spinal computed tomography(CT) and magnetic resonance imaging(MRI) revealed a collapsed T2 vertebra with an enhancing osteolytic mass. CTguided biopsy showed inconclusive morphology. Pathology from T2 corpectomy revealed GCRO. The patient subsequently received neoadjuvant chemotherapy followed by salvage operation of T2 costotransversectomy with grossly-total resection adjuvant chemoradiation. Upon treatment completion, she had complete GCRO remission. The 4-year follow-up spinal MRI showed no tumor recurrence.CONCLUSION Spinal GCRO poses unique challenges in obtaining sufficient tissue diagnosis and complete surgical removal. However, long-term local control of spinal GCRO is possible following complete resection and adjuvant chemoradiation.展开更多
Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells(OGCs)is very rare,less than1%of all pancreatic malignancies,and shows worse prognosis than that of invasive ductal adenocarcinoma of the panc...Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells(OGCs)is very rare,less than1%of all pancreatic malignancies,and shows worse prognosis than that of invasive ductal adenocarcinoma of the pancreas.We present a case of en bloc resection for a huge undifferentiated carcinoma with OGCs that invaded the stomach and transverse mesocolon.A 67-year female was admitted for left upper quadrant pain and computed tomography demonstrated a mass occupying the lesser sac and abutting the stomach and pancreas.There were no distant metastases and the patient underwent subtotal pancreatectomy with splenectomy,total gastrectomy,and segmental resection of the transverse colon.Histopathological examination confirmed an 11 cm-sized undifferentiated carcinoma of the pancreas with OGCs.Immunohistochemical staining revealed reactivity with pan-cytokeratin in adenocarcinoma component,with vimentin in neoplastic multinucleated cells,with CD45/CD68 in OGCs,and with p53 in tumor cells,respectively.The patient had suffered from multiple bone metastases and survived9 mo after surgery.This case supports the ductal epithelial origin of undifferentiated carcinoma with OGCs and early diagnosis could result in favorable surgical outcomes.Investigations on the surgical role and prog-nostic factors need to be warranted in this tumor.展开更多
Osteoclast-like giant cell tumors (OGCT) are rare abdominal tumors, which mainly occur in the pancreas. The neoplasms are composed of two distinct cell populations and frequently show an inhomogenous appearance with...Osteoclast-like giant cell tumors (OGCT) are rare abdominal tumors, which mainly occur in the pancreas. The neoplasms are composed of two distinct cell populations and frequently show an inhomogenous appearance with cystic structures. However, due to the rarity of these tumors, only very limited clinical data are available. Imaging features and sonographic appearance have hardly been characterized. Here we report on two cases of osteoclast-like giant cell tumors, one located within the pancreas, the other within the liver, in which OGCTs are extremely rare. Both patients were investigated by contrast sonography, which demonstrated a complex, partly cystic and strongly vascularized tumor within the head of the pancreas in the first patient and a large, hypervascularized neoplasm with calcifications within the liver in the second patient. The liver OGCT responded well to a combination of carboplatin, etoposide and paclitaxel. With a combination of surgical resection, radiofrequency ablation and chemotherapy, the patient's survival is currently more than 15 too, making him the longest survivor with an OGCT of the liver to date.展开更多
BACKGROUND: Giant cell tumors are rare and highly malignant tumors of the pancreas. Based on two distinct cell populations, they have been divided into two subtypes corresponding to the osteoclast-like giant cell tumo...BACKGROUND: Giant cell tumors are rare and highly malignant tumors of the pancreas. Based on two distinct cell populations, they have been divided into two subtypes corresponding to the osteoclast-like giant cell tumor and the pleomorphic giant cell carcinoma of the pancreas. Distinctive imaging features of the tumors remain uncharacterized. Surgical removal is the only appropriate treatment for them, but responses to chemotherapy or radiotherapy remain undocumented. METHODS: Clinical, radiological, histopathologic, and immuno- histochemical features of two cases of giant cell tumor of the pancreas are presented along with a brief review of the literature. RESULTS: En-bloc resection was done successfully in both cases. The patient with an osteoclast-like giant cell tumor remained disease-free with no clinical or radiological evidence of recurrence at 6 months after surgery. However, the patient with the pleomorphic type died 4 months later due to diffuse pulmonary metastasis. CONCLUSIONS: En-bloc surgical resection is the only appropriate treatment for giant cell tumors. The overall prognosis of these tumors is poorer than that of pancreatic ductal adenocarcinoma, especially the pleomorphic type. More studies are required to document the management and outcomes of the tumors.展开更多
BACKGROUND Giant cell tumor(GCT)is a benign lesion and rarely involves the patella.This disease is characterized by a relatively high recurrence rate after primary treatment.En bloc resection has been a predominant op...BACKGROUND Giant cell tumor(GCT)is a benign lesion and rarely involves the patella.This disease is characterized by a relatively high recurrence rate after primary treatment.En bloc resection has been a predominant option for recurrent GCT.However,total patellectomy can lead to disruption of the knee.Therefore,exploration of functional reconstruction of the extensor mechanism is worthwhile.CASE SUMMARY A 54-year-old woman presented with right knee pain and swelling,and was diagnosed as having a GCT in the patella following curettage and autograft.Medical imaging revealed a lytic and expanded lesion involving the whole patella with focal cortical breaches and pathological fracture.Based on the combination of histological,radiological,and clinical features,a diagnosis of recurrent GCT in the patella was made(Campanacci grade III).After a multidisciplinary team discussion,three-dimensional(3D)-printed custom-made patellar endoprosthesis was performed following en bloc resection for reconstructing the extensor mechanism.The patient was followed for 35 mo postoperatively.No evidence of local recurrence,pulmonary metastasis,or osteoarthritis of the right knee was observed.The active flexion arc was 0°-120°,and no extension lag was detected.A favorable patellar tracking and height(Insall-Salvati ratio 0.93)were detected by radiography.CONCLUSION We depict a case of a GCT at the right patella,which was successfully treated by patellectomy and 3D-printed custom-made endoprosthetic replacement.The patella normal reconstruction,the precise-fit articular design,and gastrocnemius flap augmentation could lead to satisfactory knee function and a low rate of complications in the short-term follow-up.展开更多
BACKGROUND Giant cell hepatitis in the adult population remains very poorly defined with only 100 case reports published in the literature over the last three decades.AIM To present our center’s experience in an atte...BACKGROUND Giant cell hepatitis in the adult population remains very poorly defined with only 100 case reports published in the literature over the last three decades.AIM To present our center’s experience in an attempt to learn about the predisposing factors,outcomes and efficacy of proposed therapeutic interventions for giant cell hepatitis.METHODS A retrospective chart review was conducted through the electronic records of the University of Pittsburgh Medical Center.We queried 36726 liver biopsy reports from January 1,1991 to December 6,2016.Our search yielded 50 patients who were identified as carrying a definite diagnosis of post-infantile giant cell hepatitis(PIGCH)by pathology.The data collected included demographic information,laboratory data(liver function tests,autoimmune markers)and transplant status.In order to better analyze patient characteristics and outcomes,subjects were separated into a non-transplant(native)liver group and a post-liver transplant(allograft)group.RESULTS The incidence of PIGCH was approximately 0.14%of all biopsies queried in the 25-year period.The mean age was 48 years with 66%females.Liver function tests were classified as 38.2%cholestatic,35.3%hepatocellular and 26.5%mixed.Autoimmune hepatitis was found to be the most prevalent predisposing factor leading to PIGCH constituting 32%of cases.Management consisted mainly of immunosuppression,viral targeted therapy,supportive care and in six cases liver transplantations.CONCLUSION The diagnosis of PIGCH remains clinically challenging and requires a high index of suspicion as well as a thorough history,physical examination,serological workup and liver biopsy.Treatment of the underlying cause can result in clinical stability in a large number of cases.展开更多
BACKGROUND Giant cell tumors(GCT)are most commonly seen in the distal femur.These tumors are uncommon in the small bones of the hand and feet,and a very few cases have been reported.A giant cell tumor of the talus is ...BACKGROUND Giant cell tumors(GCT)are most commonly seen in the distal femur.These tumors are uncommon in the small bones of the hand and feet,and a very few cases have been reported.A giant cell tumor of the talus is rarely seen clinically and could be a challenge to physicians.CASE SUMMARY We report a rare case of GCT of the talus in one patient who underwent a new reconstructive surgery technique using a three-dimensional(3D)printing talar prosthesis.The prosthesis shape was designed by tomographic image processing and segmentation using technology to match the intact side by mirror symmetry with 3D post-processing technologies.The patient recovered nearly full range of motion of the ankle after 6 mo.The visual analogue scale and American Orthopaedic Foot and Ankle Society scores were 1 and 89 points,respectively.CONCLUSION We demonstrated that 3D printing of a talar prosthesis is a beneficial option for GCT of the talus.展开更多
BACKGROUND No qualitative or quantitative analysis of contrast-enhanced computed tomography(CT)images has been reported for the differentiation between ameloblastomas and central giant cell granulomas(CGCGs).AIM To de...BACKGROUND No qualitative or quantitative analysis of contrast-enhanced computed tomography(CT)images has been reported for the differentiation between ameloblastomas and central giant cell granulomas(CGCGs).AIM To describe differentiating multidetector CT(MDCT)features in CGCGs and ameloblastomas and to compare differences in enhancement of these lesions qualitatively and using histogram analysis.METHODS MDCT of CGCGs and ameloblastomas was retrospectively reviewed to evaluate qualitative imaging descriptors.Histogram analysis was used to compare the extent of enhancement of the soft tissue.Fisher’s exact tests and Mann–Whitney U test were used for statistical analysis(P<0.05).RESULTS Twelve CGCGs and 33 ameloblastomas were reviewed.Ameloblastomas had a predilection for the posterior mandible with none of the CGCGs involving the angle.CGCGs were multilocular(58.3%),with a mixed lytic sclerotic appearance(75%).Soft tissue component was present in 91%of CGCGs,which showed hyperenhancement(compared to surrounding muscles)in 50%of cases,while the remaining showed isoenhancement.Matrix mineralization was present in 83.3%of cases.Ameloblastomas presented as a unilocular(66.7%),lytic(60.6%)masses with solid components present in 81.8%of cases.However,the solid component showed isoenhancement in 63%.No matrix mineralization was present in 69.7%of cases.Quantitatively,the enhancement of soft tissue in CGCG was significantly higher than in ameloblastoma on histogram analysis(P<0.05),with a minimum enhancement of>49.05 HU in the tumour providing 100%sensitivity and 85%specificity in identifying a CGCG.CONCLUSION A multilocular,lytic sclerotic lesion with significant hyperenhancement in soft tissue,which spares the angle of the mandible and has matrix mineralization,should indicate prospective diagnosis of CGCG.展开更多
BACKGROUND Malignant giant cell tumor of the tendon sheath(MGCTTS)is an extremely rare malignant tumor originating from synovial and tendon sheath tissue with highly aggressive biological behavior and a high rate of l...BACKGROUND Malignant giant cell tumor of the tendon sheath(MGCTTS)is an extremely rare malignant tumor originating from synovial and tendon sheath tissue with highly aggressive biological behavior and a high rate of local recurrence and distant metastasis which should be considered a highly malignant sarcoma and managed aggressively.How to systemically treat MGCTTS remains a challenge.In this case,a patient with MGCTTS suffered a recurrence after 2 surgical resections received adjuvant chemotherapy and radiation therapy,but the treatment outcome remained poor.More clinical trials and better understanding of the biology and molecular aspects of this subtype of sarcoma are needed while novel medicines should be developed to efficiently target particular pathways.CASE SUMMARY A 52-year-old man presented with persistent dull pain in the right groin accompanied by limited right hip motion starting 6 mo ago.Two months before his attending to hospital,the patient’s pain worsened,presenting as severe pain when standing or walking,limping,and inability to straighten or move the right lower extremity.Surgical excision was performed and MGCTTS was confirmed by pathology examination.Two recurrences occurred after surgical resection,moreover,the treatment outcome remained poor after adjuvant chemotherapy and radiation therapy.The patient died only 10 mo after the initial diagnosis.CONCLUSION MGCTTS is characterized by a joint mass with pain and limited motion.It typically grows along the tendons and infiltrated into the surrounding muscle and bone tissue,with a stubborn tendency to relapse,as well as pulmonary metastasis.Radically surgical resection provides a choice of treatment whereas post-operation care should be taken to preserve the function of the joint.Chemotherapy and radiotherapy can be used as alternative treatments when radical resection cannot be performed.展开更多
Giant cell tumor of the bone(GCTB)is a benign,locally aggressive neoplasm that is relatively rare,with a propensity to result in progressive bone destruction,and is associated with a high risk of recurrence.There is n...Giant cell tumor of the bone(GCTB)is a benign,locally aggressive neoplasm that is relatively rare,with a propensity to result in progressive bone destruction,and is associated with a high risk of recurrence.There is no widely held consensus regarding its ideal treatment.Worldwide,there are varying techniques ranging from intralesional curettage to resection of the lesion,supplemented with combinations of numerous adjuncts and fillers,depending on the resected amount and integrity of bone,as well as the preference of the surgeon.This was a cross-sectional study that included 20 patients who underwent limb salvage surgery for giant cell tumor of the bone of the lower extremities from January 2009 to February 2020 at two tertiary hospitals.The mean follow-up period was 37.3 months(SD=2.84).The extended curettage(EC)group had a mean Musculoskeletal Tumor Rating Scale(MSTS)score of 28.18(SD=7.51)which is considered as an excellent outcome,while the resection(RS)group had an mean MSTS score of 19.67(SD=11.02),which is considered as a good outcome.EC resulted to a total of eight complications(47%),while RS had one complication(33%).Prevalence of recurrence was noted to be 11.75%among those who underwent EC,while no recurrence was noted among those in the RS group.Use of bone cement as a filler was noted to have less recurrence as compared with the use of bone grafts,however were both were noted to result in excellent functional outcomes.Despite the prevalence of complications and recurrence of GCTB of the salvaged extremity in those who underwent EC,there is still report of excellent functionality.It is hence important to disclose all these possible outcomes and to stress the importance of compliance to follow-up for monitoring of these events.展开更多
A giant cell tumor occurs mainly in the proximal tibia,humerus,distal radius bone and the pelvic bone.It is rarely observed in such sites as the ribs and the temporal bone.The condition is primarily treated with surgi...A giant cell tumor occurs mainly in the proximal tibia,humerus,distal radius bone and the pelvic bone.It is rarely observed in such sites as the ribs and the temporal bone.The condition is primarily treated with surgical excision and functional reconstruction.The effect of chemotherapy on lung metastases and locally advanced giant cell tumors has remained unknown.We collected and analyzed the data of six patients with rare giant cell tumors located in the head and neck patients.After an average follow-up of 42.6 months after surgery (14 to 90 months),no local recurrence or metastasis was observed.We also collected and analyzed the data of five patients with metastatic giant cell tumors who were undergoing surgery for the primary tumor before; of three patients who had experienced multiple chemotherapy cycles,one had spontaneous regression,and one survived for long timer despite progression.The other two patients had their major metastatic lesions resected by surgery,and presented long-term survival during the follow up.In addition,this study reports one patient with locally advanced giant cell tumor of the rib,who has undergone successful surgical resection following two cycles of chemotherapy with ifosfamide and liposomal doxorubicin.Complete resection of the lesion at the head and neck is the key to relapse-free survival.The prognosis of lung metastases in patients with giant cell tumors is relatively satisfying.Neoadjuvant chemotherapy is also conducive to the surgery for locally advanced lesions and improvement of the quality of life.展开更多
BACKGROUND Tenosynovial giant cell tumors(TGCTs)are a frequent benign proliferative disease originating from the synovial membrane.However,TGCTs rarely occur in the spine.The purpose of this paper is to report a case ...BACKGROUND Tenosynovial giant cell tumors(TGCTs)are a frequent benign proliferative disease originating from the synovial membrane.However,TGCTs rarely occur in the spine.The purpose of this paper is to report a case of TGCT occurring in the cervical spine.Although the disease is rare,it is essential to consider the possibility of TGCT in axial skeletal lesions.Awareness of spinal TGCTs is important because their characteristics are similar to common spinal tumor lesions.CASE SUMMARY A 49-year-old man with a 2-year history of neck pain and weakness in both lower extremities was referred to our ward.Imaging revealed a mass extending from the left epidural space to the C4-5 paravertebral muscles with uneven enhancement.The tumor originated in the synovium of the C4-5 lesser joint and eroded mainly the C4-5 vertebral arch and spine.Puncture biopsy was suggestive of a giant cellrich lesion.The patient had pulmonary tuberculosis,and we first administered anti-tuberculosis treatment.After the preoperative requirements of the antituberculosis treatment were met,we used a posterior cervical approach to completely remove the mass after fixation with eight pedicle screws.The mass was identified as a TGCT by postoperative immunohistochemical analysis.Recurrence was not detected after 1 year of follow-up.CONCLUSION Spinal TGCTs are often misdiagnosed.The radiological changes are not specific.The ideal treatment comprises complete excision with proper internal fixation,which can significantly reduce postoperative recurrence.展开更多
BACKGROUND Giant cell tumor of soft tissue(GCT-ST)is an extremely rare low-grade soft tissue tumor that is originates in superficial tissue and rarely spreads deeper.GCT-ST has unpredictable behavior.It is mainly beni...BACKGROUND Giant cell tumor of soft tissue(GCT-ST)is an extremely rare low-grade soft tissue tumor that is originates in superficial tissue and rarely spreads deeper.GCT-ST has unpredictable behavior.It is mainly benign,but may sometimes become aggressive and potentially increase in size within a short period of time.CASE SUMMARY A 17-year-old man was suspected of having a fracture,based on radiography following left shoulder trauma.One month later,the swelling of the left shoulder continued to increase and the pain was obvious.Computed tomography(CT)revealed a soft tissue mass with strip-like calcifications in the left shoulder.The mass invaded the adjacent humerus and showed an insect-like area of destruction at the edge of the cortical bone of the upper humerus.The marrow cavity of the upper humerus was enlarged,and a soft tissue density was seen in the medullary cavity.Thoracic CT revealed multiple small nodules beneath the pleura of both lungs.A bone scan demonstrated increased activity in the left shoulder joint and proximal humerus.The mass showed mixed moderate hypointensity and hyperintensity on T1-weighted images,and mixed hyperintensity on T2-weighted fat-saturated images.The final diagnosis of GCT-ST was confirmed by pathology.CONCLUSION GCT-STs should be considered in the differential diagnosis of soft tissue tumors and monitored for large increases in size.展开更多
BACKGROUND Giant cell tumor(GCT)of the anterior rib origin is extremely rare.We report the first case of trauma-induced GCT of the rib.CASE SUMMARY A 22-year-old female developed a mass over the right anterior chest w...BACKGROUND Giant cell tumor(GCT)of the anterior rib origin is extremely rare.We report the first case of trauma-induced GCT of the rib.CASE SUMMARY A 22-year-old female developed a mass over the right anterior chest wall with pain 3 mo after a falling injury with blunt trauma of the right chest wall.Chest computed tomography(CT)showed a tumor originating from the right 6th rib with bony destruction,and a CT-guided needle biopsy revealed a GCT.We completely resected the tumor with chest wall and performed reconstruction.The pathological diagnosis was GCT of the bone.Twelve months after surgery,no signs of recurrence were observed.CONCLUSION GCT of the rib after trauma has not been reported.Meticulous history-taking and image evaluation are essential for the differential diagnosis of unusual chest wall tumors.展开更多
Human LAK cells were prepared by culturing normal human peripheral blood mononuclear cells (PBMC) with or without rIL-2 and assayed for T cell surface markers as well as anti-tumor activity against PC in vitro and in ...Human LAK cells were prepared by culturing normal human peripheral blood mononuclear cells (PBMC) with or without rIL-2 and assayed for T cell surface markers as well as anti-tumor activity against PC in vitro and in nude mice. Although the percentages of T3, T4, and T8 positive cells in rIL-2-activated cells did not differ significantly from those of control cells in vitro, the former showed stronger cytotoxicity than control cells to PG tumor cells in vitro. In vivo, LAK cells completely inhibited the growth of PG tumor in nude mice, whereas PBMC control cells were to be of no effect. The anti-tumor effect of human LAK cells in nude mice may offer a useful model to study the role of human LAK cells against human tumor in vivo.展开更多
基金Supported by The Shanghai Municipal Health Commission Clinical Research Project,No.202140140.
文摘BACKGROUND For patients with acute paraplegia caused by spinal giant cell tumor(GCT)who require emergency decompressive surgery,there is still a lack of relevant reports on surgical options.This study is the first to present the case of an acute paraplegic patient with a thoracic spinal GCT who underwent an emergency total en bloc spondylectomy(TES).Despite tumor recurrence,three-level TES was repeated after denosumab therapy.CASE SUMMARY A 27-year-old female patient who underwent single-level TES in an emergency presented with sudden severe back pain and acute paraplegia due to a thoracic spinal tumor.After emergency TES,the patient's spinal cord function recovered,and permanent paralysis was avoided.The postoperative histopathological examination revealed that the excised neoplasm was a rare GCT.Unfortunately,the tumor recurred 9 months after the first surgery.After 12 months of denosumab therapy,the tumor size was reduced,and tumor calcification.To prevent recurrent tumor progression and provide a possible cure,a three-level TES was performed again.The patient returned to an active lifestyle 1 month after the second surgery,and no recurrence of GCT was found at the last follow-up.CONCLUSION This patient with acute paraplegia underwent TES twice,including once in an emergency,and achieved good therapeutic results.TES in emergency surgery is feasible and safe when conditions permit;however,it may increase the risk of tumor recurrence.
基金Supported by the Technology Innovation Leading Program of Shaanxi,No.2023KXJ-095the Shaanxi Provincial People's Hospital Science and Technology Talent Support Program for Elite Talents,No.2021JY-38 and No.2021JY-50the Shaanxi Provincial People's Hospital Science and Technology Development Incubation Foundation,No.2023YJY-39.
文摘BACKGROUND Giant cell tumor of bone is a locally aggressive and rarely metastasizing tumor,and also a potential malignant tumor that may develop into a primary malignant giant cell tumor.AIM To evaluate the role of multimodal imaging in the diagnosis of giant cell tumors of bone.METHODS The data of 32 patients with giant cell tumor of bone confirmed by core-needle biopsy or surgical pathology at our hospital between March 2018 and March 2023 were retrospectively selected.All the patients with giant cell tumors of the bone were examined by X-ray,computed tomography(CT)and magnetic resonance imaging(MRI),and 7 of them were examined by positron emission tomography(PET)-CT.RESULTS X-ray imaging can provide overall information on giant cell tumor lesions.CT and MRI can reveal the characteristics of the internal structure of the tumor as well as the adjacent relationships of the tumor,and these methods have unique advantages for diagnosing tumors and determining the scope of surgery.PET-CT can detect small lesions and is highly valuable for identifying benign and malignant tumors to aid in the early diagnosis of metastasis.CONCLUSION Multimodal imaging plays an important role in the diagnosis of giant cell tumor of bone and can provide a reference for the treatment of giant cell tumors.
文摘BACKGROUND Invasive breast carcinoma with osteoclast-like stromal giant cells(OGCs) is an extremely rare morphology of breast carcinomas.To the best of our knowledge,the most recent case report describing this rare pathology was published six years ago.The mechanism controlling the development of this unique histological formation is still unknown.Further,the prognosis of patients with OGC involvement is also controversial.CASE SUMMARY We report the case of a 48-year-old woman,who presented to the outpatient department with a palpable,growing,painless mass in her left breast for about one year.Sonography and mammography revealed a 26.5 mm ×18.8 mm asymmetric,lobular mass with circumscribed margin and the Breast Imaging Reporting and Data System was category 4C.Sono-guided aspiration biopsy revealed invasive ductal carcinoma.The patient underwent breast conserving surgery and was diagnosed with invasive breast carcinoma with OGCs,grade Ⅱ,with intermediate grade of ductal carcinoma in situ(ER:80%,3+,PR:80%,3+,HER-2:negative,Ki 67:30%).Adjuvant chemotherapy and post-operation radiotherapy were initiated thereafter.CONCLUSION As a rare morphology of breast cancer,breast carcinoma with OGC occurs most often in relatively young women,has less lymph node involvement,and its occurrence is not racedependent.
文摘BACKGROUND Aggressive giant cell tumor of the distal fibula is so rare that no consensus on a surgical strategy has been reached.Thus,an appropriate treatment strategy is still important to discuss.CASE SUMMARY A 61-year-old man who had been experiencing progressive swelling of the left lateral malleolus accompanied by pain for half a year was presented at our hospital.He had never been treated prior to coming to our hospital.Preoperative imaging revealed a 10 cm×6 cm mass located in the body of the distal fibula.Pathological biopsies confirmed it was a giant cell tumor.Preoperative examination revealed he had dilated cardiomyopathy with class 3 cardiac function.The cardiologist and anesthesiologist determined that he could tolerate the operation,but the operation should be as short and minimally invasive as possible.With the patient’s consent,we performed a tibiotalar fusion and followed up with him for 2years,finding no recurrence and a satisfactory recovery.CONCLUSION Tibial talus fusion is an effective method for the treatment of distal fibula tumors.
基金the European Union-NextGenerationEU,through the National Recovery and Resilience Plan of the Republic of Bulgaria,No.BG-RRP-2.004-0008.
文摘BACKGROUND Multinucleated giant cells(MGCs)in bladder carcinomas are poorly studied.AIM To describe the function,morphogenesis,and origin of mononuclear and MGCs in urothelial carcinoma(UC)of the bladder in Bulgarian and French patients.METHODS Urothelial bladder carcinomas(n=104)from 2016-2020 were analyzed retrospectively using immunohistochemical(IHC)and histochemical stain examination.Giant cells in the bladder stroma were found in 35.6%of cases,more often in highgrades.RESULTS We confirm that MGCs in the mucosa in UC of the bladder were positive for both mesenchymal and myofibroblast markers(vimentin,smooth muscle actin,Desmin,and CD34)and the macrophage marker CD68.Furthermore,IHC studies revealed the following profile of these cells:Positive for p16;negative for epithelial(CK AE1/AE3 and GATA-3),vascular(CD31),neural(PS100 and CKIT),cambial,blastic(CD34-blasts and C-KIT),and immune markers(IG G,immunoglobulin G4,and PD-L1);no proliferative activity,possess no specific immune function,and cannot be used to calculate the Combined Positive Score scale.CONCLUSION In conclusion,the giant stromal cells in non-tumor and tumor bladder can be used as a characteristic and relatively constant,although nonspecific,histological marker for chronic bladder damage,reflecting the chronic irritation or inflammation.Likewise,according to the morphological and IHC of the mono-and multinucleated giant cells in the bladder,they are most likely represent telocytes capable of adapting their morphology to the pathology of the organ.
文摘BACKGROUND Giant cell-rich osteosarcoma(GCRO) is a rare histological variant of osteosarcoma. Spinal GCROs are extremely rare, with challenging diagnosis and management. Herein, we present a case of spinal GCRO at T2, which was not diagnosed in initial biopsy but after T2 corpectomy. We detailed the clinical course, management strategy, and outcome after a 4-year follow-up.CASE SUMMARY A 17-year-old female patient presented with back pain followed by ascending paresthesia. Spinal computed tomography(CT) and magnetic resonance imaging(MRI) revealed a collapsed T2 vertebra with an enhancing osteolytic mass. CTguided biopsy showed inconclusive morphology. Pathology from T2 corpectomy revealed GCRO. The patient subsequently received neoadjuvant chemotherapy followed by salvage operation of T2 costotransversectomy with grossly-total resection adjuvant chemoradiation. Upon treatment completion, she had complete GCRO remission. The 4-year follow-up spinal MRI showed no tumor recurrence.CONCLUSION Spinal GCRO poses unique challenges in obtaining sufficient tissue diagnosis and complete surgical removal. However, long-term local control of spinal GCRO is possible following complete resection and adjuvant chemoradiation.
文摘Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells(OGCs)is very rare,less than1%of all pancreatic malignancies,and shows worse prognosis than that of invasive ductal adenocarcinoma of the pancreas.We present a case of en bloc resection for a huge undifferentiated carcinoma with OGCs that invaded the stomach and transverse mesocolon.A 67-year female was admitted for left upper quadrant pain and computed tomography demonstrated a mass occupying the lesser sac and abutting the stomach and pancreas.There were no distant metastases and the patient underwent subtotal pancreatectomy with splenectomy,total gastrectomy,and segmental resection of the transverse colon.Histopathological examination confirmed an 11 cm-sized undifferentiated carcinoma of the pancreas with OGCs.Immunohistochemical staining revealed reactivity with pan-cytokeratin in adenocarcinoma component,with vimentin in neoplastic multinucleated cells,with CD45/CD68 in OGCs,and with p53 in tumor cells,respectively.The patient had suffered from multiple bone metastases and survived9 mo after surgery.This case supports the ductal epithelial origin of undifferentiated carcinoma with OGCs and early diagnosis could result in favorable surgical outcomes.Investigations on the surgical role and prog-nostic factors need to be warranted in this tumor.
文摘Osteoclast-like giant cell tumors (OGCT) are rare abdominal tumors, which mainly occur in the pancreas. The neoplasms are composed of two distinct cell populations and frequently show an inhomogenous appearance with cystic structures. However, due to the rarity of these tumors, only very limited clinical data are available. Imaging features and sonographic appearance have hardly been characterized. Here we report on two cases of osteoclast-like giant cell tumors, one located within the pancreas, the other within the liver, in which OGCTs are extremely rare. Both patients were investigated by contrast sonography, which demonstrated a complex, partly cystic and strongly vascularized tumor within the head of the pancreas in the first patient and a large, hypervascularized neoplasm with calcifications within the liver in the second patient. The liver OGCT responded well to a combination of carboplatin, etoposide and paclitaxel. With a combination of surgical resection, radiofrequency ablation and chemotherapy, the patient's survival is currently more than 15 too, making him the longest survivor with an OGCT of the liver to date.
文摘BACKGROUND: Giant cell tumors are rare and highly malignant tumors of the pancreas. Based on two distinct cell populations, they have been divided into two subtypes corresponding to the osteoclast-like giant cell tumor and the pleomorphic giant cell carcinoma of the pancreas. Distinctive imaging features of the tumors remain uncharacterized. Surgical removal is the only appropriate treatment for them, but responses to chemotherapy or radiotherapy remain undocumented. METHODS: Clinical, radiological, histopathologic, and immuno- histochemical features of two cases of giant cell tumor of the pancreas are presented along with a brief review of the literature. RESULTS: En-bloc resection was done successfully in both cases. The patient with an osteoclast-like giant cell tumor remained disease-free with no clinical or radiological evidence of recurrence at 6 months after surgery. However, the patient with the pleomorphic type died 4 months later due to diffuse pulmonary metastasis. CONCLUSIONS: En-bloc surgical resection is the only appropriate treatment for giant cell tumors. The overall prognosis of these tumors is poorer than that of pancreatic ductal adenocarcinoma, especially the pleomorphic type. More studies are required to document the management and outcomes of the tumors.
基金National Key Research and Development Program of China,No.2016YFC1102003Science and Technology Research Program of Sichuan Province,No.2020YFS0036+2 种基金Chengdu Science and Technology Program Projects,No.2017-CY02-00032-GXNational Natural Science Foundation of China,No.81801852National Key Research and Development Program of China,No.2017YFB0702604.
文摘BACKGROUND Giant cell tumor(GCT)is a benign lesion and rarely involves the patella.This disease is characterized by a relatively high recurrence rate after primary treatment.En bloc resection has been a predominant option for recurrent GCT.However,total patellectomy can lead to disruption of the knee.Therefore,exploration of functional reconstruction of the extensor mechanism is worthwhile.CASE SUMMARY A 54-year-old woman presented with right knee pain and swelling,and was diagnosed as having a GCT in the patella following curettage and autograft.Medical imaging revealed a lytic and expanded lesion involving the whole patella with focal cortical breaches and pathological fracture.Based on the combination of histological,radiological,and clinical features,a diagnosis of recurrent GCT in the patella was made(Campanacci grade III).After a multidisciplinary team discussion,three-dimensional(3D)-printed custom-made patellar endoprosthesis was performed following en bloc resection for reconstructing the extensor mechanism.The patient was followed for 35 mo postoperatively.No evidence of local recurrence,pulmonary metastasis,or osteoarthritis of the right knee was observed.The active flexion arc was 0°-120°,and no extension lag was detected.A favorable patellar tracking and height(Insall-Salvati ratio 0.93)were detected by radiography.CONCLUSION We depict a case of a GCT at the right patella,which was successfully treated by patellectomy and 3D-printed custom-made endoprosthetic replacement.The patella normal reconstruction,the precise-fit articular design,and gastrocnemius flap augmentation could lead to satisfactory knee function and a low rate of complications in the short-term follow-up.
文摘BACKGROUND Giant cell hepatitis in the adult population remains very poorly defined with only 100 case reports published in the literature over the last three decades.AIM To present our center’s experience in an attempt to learn about the predisposing factors,outcomes and efficacy of proposed therapeutic interventions for giant cell hepatitis.METHODS A retrospective chart review was conducted through the electronic records of the University of Pittsburgh Medical Center.We queried 36726 liver biopsy reports from January 1,1991 to December 6,2016.Our search yielded 50 patients who were identified as carrying a definite diagnosis of post-infantile giant cell hepatitis(PIGCH)by pathology.The data collected included demographic information,laboratory data(liver function tests,autoimmune markers)and transplant status.In order to better analyze patient characteristics and outcomes,subjects were separated into a non-transplant(native)liver group and a post-liver transplant(allograft)group.RESULTS The incidence of PIGCH was approximately 0.14%of all biopsies queried in the 25-year period.The mean age was 48 years with 66%females.Liver function tests were classified as 38.2%cholestatic,35.3%hepatocellular and 26.5%mixed.Autoimmune hepatitis was found to be the most prevalent predisposing factor leading to PIGCH constituting 32%of cases.Management consisted mainly of immunosuppression,viral targeted therapy,supportive care and in six cases liver transplantations.CONCLUSION The diagnosis of PIGCH remains clinically challenging and requires a high index of suspicion as well as a thorough history,physical examination,serological workup and liver biopsy.Treatment of the underlying cause can result in clinical stability in a large number of cases.
文摘BACKGROUND Giant cell tumors(GCT)are most commonly seen in the distal femur.These tumors are uncommon in the small bones of the hand and feet,and a very few cases have been reported.A giant cell tumor of the talus is rarely seen clinically and could be a challenge to physicians.CASE SUMMARY We report a rare case of GCT of the talus in one patient who underwent a new reconstructive surgery technique using a three-dimensional(3D)printing talar prosthesis.The prosthesis shape was designed by tomographic image processing and segmentation using technology to match the intact side by mirror symmetry with 3D post-processing technologies.The patient recovered nearly full range of motion of the ankle after 6 mo.The visual analogue scale and American Orthopaedic Foot and Ankle Society scores were 1 and 89 points,respectively.CONCLUSION We demonstrated that 3D printing of a talar prosthesis is a beneficial option for GCT of the talus.
文摘BACKGROUND No qualitative or quantitative analysis of contrast-enhanced computed tomography(CT)images has been reported for the differentiation between ameloblastomas and central giant cell granulomas(CGCGs).AIM To describe differentiating multidetector CT(MDCT)features in CGCGs and ameloblastomas and to compare differences in enhancement of these lesions qualitatively and using histogram analysis.METHODS MDCT of CGCGs and ameloblastomas was retrospectively reviewed to evaluate qualitative imaging descriptors.Histogram analysis was used to compare the extent of enhancement of the soft tissue.Fisher’s exact tests and Mann–Whitney U test were used for statistical analysis(P<0.05).RESULTS Twelve CGCGs and 33 ameloblastomas were reviewed.Ameloblastomas had a predilection for the posterior mandible with none of the CGCGs involving the angle.CGCGs were multilocular(58.3%),with a mixed lytic sclerotic appearance(75%).Soft tissue component was present in 91%of CGCGs,which showed hyperenhancement(compared to surrounding muscles)in 50%of cases,while the remaining showed isoenhancement.Matrix mineralization was present in 83.3%of cases.Ameloblastomas presented as a unilocular(66.7%),lytic(60.6%)masses with solid components present in 81.8%of cases.However,the solid component showed isoenhancement in 63%.No matrix mineralization was present in 69.7%of cases.Quantitatively,the enhancement of soft tissue in CGCG was significantly higher than in ameloblastoma on histogram analysis(P<0.05),with a minimum enhancement of>49.05 HU in the tumour providing 100%sensitivity and 85%specificity in identifying a CGCG.CONCLUSION A multilocular,lytic sclerotic lesion with significant hyperenhancement in soft tissue,which spares the angle of the mandible and has matrix mineralization,should indicate prospective diagnosis of CGCG.
基金Supported by The Beijing Science Foundation for Distinguished Young Scholars,No.JQ21025。
文摘BACKGROUND Malignant giant cell tumor of the tendon sheath(MGCTTS)is an extremely rare malignant tumor originating from synovial and tendon sheath tissue with highly aggressive biological behavior and a high rate of local recurrence and distant metastasis which should be considered a highly malignant sarcoma and managed aggressively.How to systemically treat MGCTTS remains a challenge.In this case,a patient with MGCTTS suffered a recurrence after 2 surgical resections received adjuvant chemotherapy and radiation therapy,but the treatment outcome remained poor.More clinical trials and better understanding of the biology and molecular aspects of this subtype of sarcoma are needed while novel medicines should be developed to efficiently target particular pathways.CASE SUMMARY A 52-year-old man presented with persistent dull pain in the right groin accompanied by limited right hip motion starting 6 mo ago.Two months before his attending to hospital,the patient’s pain worsened,presenting as severe pain when standing or walking,limping,and inability to straighten or move the right lower extremity.Surgical excision was performed and MGCTTS was confirmed by pathology examination.Two recurrences occurred after surgical resection,moreover,the treatment outcome remained poor after adjuvant chemotherapy and radiation therapy.The patient died only 10 mo after the initial diagnosis.CONCLUSION MGCTTS is characterized by a joint mass with pain and limited motion.It typically grows along the tendons and infiltrated into the surrounding muscle and bone tissue,with a stubborn tendency to relapse,as well as pulmonary metastasis.Radically surgical resection provides a choice of treatment whereas post-operation care should be taken to preserve the function of the joint.Chemotherapy and radiotherapy can be used as alternative treatments when radical resection cannot be performed.
文摘Giant cell tumor of the bone(GCTB)is a benign,locally aggressive neoplasm that is relatively rare,with a propensity to result in progressive bone destruction,and is associated with a high risk of recurrence.There is no widely held consensus regarding its ideal treatment.Worldwide,there are varying techniques ranging from intralesional curettage to resection of the lesion,supplemented with combinations of numerous adjuncts and fillers,depending on the resected amount and integrity of bone,as well as the preference of the surgeon.This was a cross-sectional study that included 20 patients who underwent limb salvage surgery for giant cell tumor of the bone of the lower extremities from January 2009 to February 2020 at two tertiary hospitals.The mean follow-up period was 37.3 months(SD=2.84).The extended curettage(EC)group had a mean Musculoskeletal Tumor Rating Scale(MSTS)score of 28.18(SD=7.51)which is considered as an excellent outcome,while the resection(RS)group had an mean MSTS score of 19.67(SD=11.02),which is considered as a good outcome.EC resulted to a total of eight complications(47%),while RS had one complication(33%).Prevalence of recurrence was noted to be 11.75%among those who underwent EC,while no recurrence was noted among those in the RS group.Use of bone cement as a filler was noted to have less recurrence as compared with the use of bone grafts,however were both were noted to result in excellent functional outcomes.Despite the prevalence of complications and recurrence of GCTB of the salvaged extremity in those who underwent EC,there is still report of excellent functionality.It is hence important to disclose all these possible outcomes and to stress the importance of compliance to follow-up for monitoring of these events.
基金funded by Guangdong Medical Science and Technology Research Fund(A2011199)WuJieping Medical Foundation Clinical Research and Special Assistance Funds(320.6750.1308)
文摘A giant cell tumor occurs mainly in the proximal tibia,humerus,distal radius bone and the pelvic bone.It is rarely observed in such sites as the ribs and the temporal bone.The condition is primarily treated with surgical excision and functional reconstruction.The effect of chemotherapy on lung metastases and locally advanced giant cell tumors has remained unknown.We collected and analyzed the data of six patients with rare giant cell tumors located in the head and neck patients.After an average follow-up of 42.6 months after surgery (14 to 90 months),no local recurrence or metastasis was observed.We also collected and analyzed the data of five patients with metastatic giant cell tumors who were undergoing surgery for the primary tumor before; of three patients who had experienced multiple chemotherapy cycles,one had spontaneous regression,and one survived for long timer despite progression.The other two patients had their major metastatic lesions resected by surgery,and presented long-term survival during the follow up.In addition,this study reports one patient with locally advanced giant cell tumor of the rib,who has undergone successful surgical resection following two cycles of chemotherapy with ifosfamide and liposomal doxorubicin.Complete resection of the lesion at the head and neck is the key to relapse-free survival.The prognosis of lung metastases in patients with giant cell tumors is relatively satisfying.Neoadjuvant chemotherapy is also conducive to the surgery for locally advanced lesions and improvement of the quality of life.
基金Supported by The National Natural Science Foundation of China(General Program),No.81472073the Natural Science Foundation of Hunan Province of China,No.2019JJ40518.
文摘BACKGROUND Tenosynovial giant cell tumors(TGCTs)are a frequent benign proliferative disease originating from the synovial membrane.However,TGCTs rarely occur in the spine.The purpose of this paper is to report a case of TGCT occurring in the cervical spine.Although the disease is rare,it is essential to consider the possibility of TGCT in axial skeletal lesions.Awareness of spinal TGCTs is important because their characteristics are similar to common spinal tumor lesions.CASE SUMMARY A 49-year-old man with a 2-year history of neck pain and weakness in both lower extremities was referred to our ward.Imaging revealed a mass extending from the left epidural space to the C4-5 paravertebral muscles with uneven enhancement.The tumor originated in the synovium of the C4-5 lesser joint and eroded mainly the C4-5 vertebral arch and spine.Puncture biopsy was suggestive of a giant cellrich lesion.The patient had pulmonary tuberculosis,and we first administered anti-tuberculosis treatment.After the preoperative requirements of the antituberculosis treatment were met,we used a posterior cervical approach to completely remove the mass after fixation with eight pedicle screws.The mass was identified as a TGCT by postoperative immunohistochemical analysis.Recurrence was not detected after 1 year of follow-up.CONCLUSION Spinal TGCTs are often misdiagnosed.The radiological changes are not specific.The ideal treatment comprises complete excision with proper internal fixation,which can significantly reduce postoperative recurrence.
文摘BACKGROUND Giant cell tumor of soft tissue(GCT-ST)is an extremely rare low-grade soft tissue tumor that is originates in superficial tissue and rarely spreads deeper.GCT-ST has unpredictable behavior.It is mainly benign,but may sometimes become aggressive and potentially increase in size within a short period of time.CASE SUMMARY A 17-year-old man was suspected of having a fracture,based on radiography following left shoulder trauma.One month later,the swelling of the left shoulder continued to increase and the pain was obvious.Computed tomography(CT)revealed a soft tissue mass with strip-like calcifications in the left shoulder.The mass invaded the adjacent humerus and showed an insect-like area of destruction at the edge of the cortical bone of the upper humerus.The marrow cavity of the upper humerus was enlarged,and a soft tissue density was seen in the medullary cavity.Thoracic CT revealed multiple small nodules beneath the pleura of both lungs.A bone scan demonstrated increased activity in the left shoulder joint and proximal humerus.The mass showed mixed moderate hypointensity and hyperintensity on T1-weighted images,and mixed hyperintensity on T2-weighted fat-saturated images.The final diagnosis of GCT-ST was confirmed by pathology.CONCLUSION GCT-STs should be considered in the differential diagnosis of soft tissue tumors and monitored for large increases in size.
文摘BACKGROUND Giant cell tumor(GCT)of the anterior rib origin is extremely rare.We report the first case of trauma-induced GCT of the rib.CASE SUMMARY A 22-year-old female developed a mass over the right anterior chest wall with pain 3 mo after a falling injury with blunt trauma of the right chest wall.Chest computed tomography(CT)showed a tumor originating from the right 6th rib with bony destruction,and a CT-guided needle biopsy revealed a GCT.We completely resected the tumor with chest wall and performed reconstruction.The pathological diagnosis was GCT of the bone.Twelve months after surgery,no signs of recurrence were observed.CONCLUSION GCT of the rib after trauma has not been reported.Meticulous history-taking and image evaluation are essential for the differential diagnosis of unusual chest wall tumors.
文摘Human LAK cells were prepared by culturing normal human peripheral blood mononuclear cells (PBMC) with or without rIL-2 and assayed for T cell surface markers as well as anti-tumor activity against PC in vitro and in nude mice. Although the percentages of T3, T4, and T8 positive cells in rIL-2-activated cells did not differ significantly from those of control cells in vitro, the former showed stronger cytotoxicity than control cells to PG tumor cells in vitro. In vivo, LAK cells completely inhibited the growth of PG tumor in nude mice, whereas PBMC control cells were to be of no effect. The anti-tumor effect of human LAK cells in nude mice may offer a useful model to study the role of human LAK cells against human tumor in vivo.