A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Maheshwari, Neha
- 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.