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Aggarwal, Roopak
- Giant Cell Tumor of Bone in Northern India-incidence, Clinical Presentation, Radiology, Histopathology and Treatment Approach
Authors
1 S.M.S.&R Gr. Noida, IN
2 CIO Lab, Pathology, VMMC and Safdarjung Hospital, New Delhi, IN
3 SMS & R, Gr. Noida, IN
Source
Indian Journal of Public Health Research & Development, Vol 4, No 2 (2013), Pagination: 215-220Abstract
Giant cell tumor is relatively uncommon benign locally aggressive neoplasm. and is still a challenge to the Surgeons in the developing countries due to limited diagnostic and therapeutic facilities.
Aim of study: This study was conducted to determine the clinical pattern of Giant cell tumors including their relative frequencies as per age and sex distributions, anatomical sites of occurrence, radiological features, histopathology features analysis and treatment approach in a tertiary care hospital of North India.
Materials and Method: This is a retrospective study of all the histopathologically confirmed Giant cell tumors seen at Safdarjang Hospital New Delhi and S.M.S. Greater Noida over a 9 year period. During this period total number of primary bone tumors were 1170.Out of these 128 were diagnosed as Giant Cell tumors and 108 cases were followed up and forms the basis of the study.
Results: Out of 108 patients there were 57 males and 51 females. Their ages ranging from 11 to 55 years with an average of 28 years. The most common sites of the lesions were the ends of long bones (90 cases), especially the distal femur (24 cases), proximal tibia (31 cases) and distal radius (11 cases). The histological pattern of giant cell tumor was rather uniform. The indispensable feature of giant cell tumor was, giant cell itself. Microscopic evidence of malignancy was found in one of our cases of giant cell tumour of recurred lesion.Various forms of treatment included were curettage, en- bloc resection and radiation.
Conclusion: Incidence of GCT was 9 % of all primary tumors. Microscopic evidence of malignancy was found in one of our cases of giant cell tumour of recurred lesion.Histological grading has little prognostic value. Benign histology does not necessarily relate to the clinical behavior of the tumor. Resection yielded the best result. Radiation therapy should be reserved for surgically inaccessible tumor because of high risk of recurrence and malignant transformation.
Keywords
Giant Cell Tumor, Histopathology, Multinucleated Giant Cell (MNGC)
References
- Werner M. Giant cell tumor of bone: morphological, biological and histogenetical aspects. Springer-Verlag. 2006; 30: 484-489.
- Huang l, Xu J, Wood DJ, Zheng MH. Gene Expression of Osteoprotegerin Ligand, Osteoprotegerin, and REceptor Activator of NFkB in Giant Cell Tumor of Bone. American Journal of Pathology2000;156: 761-767.
- Thomas DM, Skubitz T, Giant cell tumor of bone. Current Opinion in Oncology 2009;21: 338-344.
- Wuelling M, Delling G, Kaiser E. The Origin of the Neoplastic Stromal Cell in Giant Cell Tumor of Bone. Human Pathology 2003; 34: 983-993.
- DicksonBC, Li SQ, Wunder JS, Ferguson PC, Eslami B, Werier JA et al.Giant cell tumor of bone express p63. Modern Pathology 2008; 21:369-375.
- Cooper A, Travers B, Surgical essays. Vol. I, London, Cox and Son. 1818; 186-208.
- Bloodgood JC. Benign giant cell tumor of bone, Its diagnosis and conservative treatment. Am J surg 1923; 37: 105.
- Jaffe HL, Lichtenstein L, Portis RB.Giant cell tumor of bone. Its pathologic appearance, grading, supposed variants and treatment. Archives of Pathology1940;30:993-1031.
- Fletcher C.D.M., Unni K.K., Mertens F. (Eds.): World Health Organization Classification of Tumors: Pathology and Genetics of Tumors of Soft tissue and Bone. Lyon, France, IARC Press, 2002; 309-13.
- Aggarwal ND, Khosla AC, Aggarwal R.A clinicopathological study of giant cell tumor of bone. Ind J Orthop 1983; 17: 129-135.
- Tuli SM, Gupta IM, Mishra RK.A clinicopathological appraisal of treatment, complication and recurrence in giant cell tumor of bone. Ind J Cancer 1984; 21:14-22.
- Zheng MH, Robbins P, Xu J, Huang L, Wood DJ, Papadimitriou JM (2001). The histogenesis of giant cell tumor of bone: a model of interaction between neoplastic cells and osteoclasts. Histol Histopathol 16: 297-307.
- Bell RS, Harwood AR, Goodman SB, Fornasier VL.Supervoltage radiotherapy in the treatment of difficult giant-cell tumors of bone. ClinOrthop 1983; 174:208-16.
- Bennett CJ, Marcus RB, Million RR, Enneking WF.Radiation therapy for giant cell tumor of bone. Int J Radiat Oncol Biol Phys1993;26:229-304.
- Giant Cell Tumour of Tendon Sheath: a Clinicopathological Study
Authors
1 A.I.I.M.S Patna, IN
2 SMS & R GR, Noida Uttar Pradesh, IN
Source
Indian Journal of Public Health Research & Development, Vol 4, No 3 (2013), Pagination: 302-305Abstract
Giant cell tumour of tendon sheath is second most common tumour of hand with high incidence of recurrence. It is slowly progressing benign tumour arising from synovial cells of tendon sheath. It occurs at any age with peak incidence in third to fourth decade. Trauma, inflammation, metabolic diseases and a neoplastic etiology are considered as etiological factors.
Aim of study: This study was conducted to share our experience of Clinicopathological aspects of Giant cell tumours of tendon sheath including their relative frequencies as per age and sex distributions, anatomical Sites of occurrence, Fine needle aspiration cytology findings &, histopathology features in School of Medical Science Greater Noida.
Material & Methods: This is a retrospective study of Giant cell tumour of tendon sheath which was done at School of Medical sciences & Research Gr. Noida U.P India during four years from 2008 t0 2012.P atients were examined clinically, FNAC & Biopsy were done and FNAC and histopathological features were studied .
Results: There were total 5 cases of giant cell tumour of tendon sheath. Most common site was fingers of hand. Age of patients varied from 25 yrs to 60 yrs. Duration of swelling were from 1 year to 3 years. Most of the swelling were approximately 2cms in diameter, firm and painless.
FNAC of the swellings revealed sheets and clusters of oval to spindle cells intermixed with mononuclear cells and osteoclast type of giant cells, suggestive of Giant cell tumour of tendon sheath.
Histopathological findings were characteristic of GCT-TS showing foamy histiocytes, multinucleate giant cells, fibroblast like cells and foamy histiocytes. Hemosiderin laden macrophages were seen in two cases ,one case revealed diffuse fibro histiocytic proliferation
Conclusion: Giant Cell tumour is a relatively rare soft tissue tumour of uncertain histogenesis. Clinical and pathological features identified were same as those of previous studies .The basic aim of management should be early diagnosis with meticulous and complete excision to prevent recurrence.
Keywords
GCTTS (Giant Cell Tumour of Tendon Sheath), Multinucleate Giant Cells, Foamy Histiocytes, FNAC (Fine Needle Aspiration Cytology)References
- Glowacki KA, Weiss AP. Giant cell tumours of tendon sheath. Hand clin. 1995; 11:245-53.
- Darwish FM, Haddad WH. Giant cell tumour of tendon sheath: Experience with 52 cases. Singapore Med J. 2008;49(11):879-82.
- Walsh EF, Merchrefe A, Akelman E, Schiller AI. Giant cell tumour of tendon sheath. Am J Orthop (belle Mead NJ). 2005;34(3):116-21.
- Reilly KE, Stern PJ, Dale A. Recurrent giant cell tumour of the tendon sheath. J Hand Surg Am. 1999;24:1298-302.
- Kotwal PP, Gupta V, Malhotra R. Giant cell tumour of tendon sheath-is radiotherapy indicated to prevent recurrence after surgery? J Bone Joint Surg. 2000;82B:571- 573.
- AI-Qattan MM. Giant cell tumour of tendon sheath: classification and recurrence rate. J Hand Surg Br.2001;26(1):72-5.
- Phalen GS, Mc Cormack LG, Gazale WJ. Giant cell tumour of tendon sheath (benign synovioma) in the hand: evaluation of 56 cases. Clin Orthop.1959;15: 140-51.
- David R, Lucas MD. Tenosynovial giant cell tumor. Case report and review. Arch Pathol Lab MED. 2012;136-901-906
- Jaffe HL, LIchtenstien HL, Elsutro CJ. Pigmented villonodularsynovitis, bursitis and tenosynovitis. Arch Pathol 1941; 31:731-65.
- Wright CJE. Benign Giant Cell Synovioma. An investigation of 85 cases. Br J Surg.1951; 38(151):257-71.
- Monaghan H, Salter DM, AI – Naffusi A. Giant cell tumour of tendon sheath (localised nodular tenosynovitis: Clinicopathological features of 71 cases. J ClinPathol. 2001;54 (5):404-7.
- O’ Connell JX, Wehrli BM, Nielsen GP et al. Giant cell tumours of soft tissue: a clinicopathologic study of 18 benign and malignant tumours. Am J Surg Pathol 2000; 24:386-95.
- Rodrigues C, Dasai S, Chinoy R. Giant cell tumour of the tendon sheath: a retrospective study of 28 cases. J SurgOncol 1998; 68:100-3.