Brown tumor of the iliac crest initially misdiagnosed as a giant cell tumor of the bone

Summary Brown tumors (BTs) are expansile osteolytic lesions complicating severe primary hyperparathyroidism (PHPT). Clinical, radiological and histological features of BTs share many similarities with other giant cell-containing lesions of the bone, which can make their diagnosis challenging. We report the case of a 32-year-old man in whom an aggressive osteolytic lesion of the iliac crest was initially diagnosed as a giant cell tumor by biopsy. The patient was scheduled for surgical curettage, with a course of neoadjuvant denosumab. Routine biochemical workup prior to denosumab administration incidentally revealed high serum calcium levels. The patient was diagnosed with PHPT and a parathyroid adenoma was identified. In light of these findings, histological slices of the iliac lesion were reviewed and diagnosis of a BT was confirmed. Follow-up CT-scans performed 2 and 7 months after parathyroidectomy showed regression and re-ossification of the bone lesion. The aim of this case report is to underline the importance of distinguishing BTs from other giant cell-containing lesions of the bone and to highlight the relevance of measuring serum calcium as part of the initial evaluation of osteolytic bone lesions. This can have a major impact on patients’ management and can prevent unnecessary invasive surgical interventions. Learning points: Although rare, brown tumors should always be considered in the differential diagnosis of osteolytic giant cell-containing bone lesions. Among giant cell-containing lesions of the bone, the main differential diagnoses of brown tumors are giant cell tumors and aneurysmal bone cysts. Clinical, radiological and histological characteristics can be non-discriminating between brown tumors and giant cell tumors. One of the best ways to distinguish these two diagnoses appears to be through biochemical workup. Differentiating brown tumors from giant cell tumors and aneurysmal bone cysts is crucial in order to ensure better patient care and prevent unnecessary morbid surgical interventions.

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Giant Cell Tumor of the Talar Neck

Journal of the American Podiatric Medical Association ◽

10.7547/0970225 ◽

2007 ◽

Vol 97 (3) ◽

pp. 225-228 ◽

Cited By ~ 7

Author(s):

Hakan Selek ◽

Hamza Özer ◽

Sacit Turanli ◽

Özlem Erdem

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Clinical Signs ◽

Cell Tumor ◽

Giant Cell Tumors ◽

Radiographic Appearance ◽

Aneurysmal Bone Cysts ◽

Tumors Of Bone ◽

Brown Tumors ◽

Small Bones

We describe a patient with a giant cell tumor in the talar head and neck of the left foot who was diagnosed as having osteochondritis dissecans and treated with arthroscopic drilling in this same location 3 years earlier. Giant cell tumors can be confused with several conditions, including giant cell reparative granulomas, brown tumors, and aneurysmal bone cysts. Giant cell tumors of bone typically occur in the epiphysis of long bones, including the distal femur and proximal tibia. They are uncommonly found in the small bones of the foot or ankle, and talar involvement is rare. Despite this rarity, the radiographic appearance and clinical signs of talar lesions should be considered in the differential diagnosis of nontraumatic conditions in the foot. (J Am Podiatr Med Assoc 97(3): 225–228, 2007)

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Differential diagnosis of bone cysts of long tubular bones of the extremities in children

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors16467 ◽

2021 ◽

Vol 9 (1) ◽

pp. 63-76

Author(s):

Ihar E. Shpileuski

Keyword(s):

Differential Diagnosis ◽

Giant Cell ◽

Fibrous Dysplasia ◽

Bone Neoplasms ◽

Benign Tumors ◽

Bone Lesions ◽

Bone Cysts ◽

Giant Cell Tumors ◽

Surgical Interventions ◽

Aneurysmal Bone Cysts

BACKGROUND: Bone cysts are characteristic tumor-like bone lesions occurring in childhood. Overall, they represent 21% to 57% of all benign tumors and tumor-like bone lesions in children. Clinical and X-ray symptoms of aneurysmal and simple bone cysts are similar. Like some other, often occurring, benign bone lesions, such as enchondromas, giant cell tumors, fibrous dysplasia, and metaphysical fibrosis defects. AIM: This study aims to identify the main clinical and instrumental characteristics of simple and aneurysmal bone cysts that allow us to differentiate them from some similar destructive bone neoplasms (enchondromas, giant cell tumors, fibrous dysplasia, and metaphysical fibrosis defects) and to develop indications for various diagnostic surgical interventions. MATERIALS AND METHODS: A retrospective analysis of the results of the survey of 206 patients aged 3 to 18 years who were treated at our facility from 2000 to 2015 was performed. The features of the diagnostic tactics and their effectiveness were rated. RESULTS: The main clinical and instrumental diagnostic criteria have been established. They enable the differentiation of bone cysts from some similar benign bone lesions at the pre-morphological stage. The indications for diagnostic surgical interventions have been formulated. CONCLUSION: The main difficulties in the differential diagnosis of bone cysts and some similar benign bone lesions have been revealed. An algorithm for applying various diagnostic surgical interventions in patients with these diseases has been proposed.

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p63 Expression in Giant Cell–Containing Lesions of Bone and Soft Tissue

Archives of Pathology & Laboratory Medicine ◽

10.5858/2010-0291-oa.1 ◽

2011 ◽

Vol 135 (6) ◽

pp. 776-779 ◽

Cited By ~ 1

Author(s):

Gustavo de la Roza

Keyword(s):

Soft Tissue ◽

Giant Cell Tumor ◽

Giant Cell ◽

Predictive Value ◽

Cell Tumor ◽

Bone Cysts ◽

Giant Cell Tumors ◽

Aneurysmal Bone Cysts ◽

Tumors Of Bone ◽

Pigmented Villonodular

Abstract Context.—Previous studies have demonstrated p63 overexpression in giant cell tumors of bone and advocate its use as a potential diagnostic marker. Although routine histology is often all that is required to diagnose giant cell tumor of bone, immunohistochemistry could prove useful to distinguish it from other benign and malignant giant cell–containing lesions of bone and soft tissue on needle biopsies and unusual clinical settings. Objective.—To assess p63 expression in giant cell–containing lesions of bone and soft tissue. Design.—p63 immunohistochemistry was performed in 23 giant cell tumors of bone, 8 primary aneurysmal bone cysts, 12 chondroblastomas, 4 giant cell reparative granulomas, 4 osteosarcomas, 15 tenosynovial giant cell tumors, 6 nonossifying fibromas, and 4 pigmented villonodular synovitides. Results.—p63 overexpression was identified in 20 of 23 giant cell tumors of bone (86.9%), 5 of 8 primary aneurysmal bone cysts (62.5%), 10 of 12 chondroblastomas (83.3%), 4 of 4 giant cell reparative granulomas (100%), 2 of 4 osteosarcomas (50%), 1 of 15 tenosynovial giant cell tumors (6.6%), 1 of 6 nonossifying fibromas (16.6%), and 1 of 4 pigmented villonodular synovitides (25%). The sensitivity, specificity, positive predictive value, and negative predictive value of p63 immunohistochemistry for the diagnosis of giant cell tumor of bone were 86.95%, 53.36%, 45.45%, and 91.17%, respectively. Conclusions.—This study shows that although p63 is expressed by most giant cell tumors of bone, its lack of specificity limits its use as an immunohistochemical marker in the differential diagnosis of giant cell–containing lesions of bone and soft tissue.

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Giant Cell Tumor of Bone in Patients under 16 Years Old: A Single-Institution Case Series

Cancers ◽

10.3390/cancers13112585 ◽

2021 ◽

Vol 13 (11) ◽

pp. 2585

Author(s):

Francesca Ambrosi ◽

Alberto Righi ◽

Stefania Benini ◽

Giovanna Magagnoli ◽

Ilaria Chiaramonte ◽

...

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Pediatric Patients ◽

Case Series ◽

Gene Mutations ◽

Cell Tumor ◽

Control Group ◽

Giant Cell Tumors ◽

Aneurysmal Bone Cysts ◽

Tumors Of Bone

Background: Giant cell tumor of bone is a locally aggressive, rarely metastasizing tumor that accounts for about 5% of bone tumors and generally occurs in patients between 20 and 45 years old. A driver mutation in the histone 3.3 (H3.3) gene H3F3A has been identified in as many as 96% of giant cell tumors of bone. The immunohistochemical expression of H3F3A H3.3 G34 expression was found in 97.8% of cases. In the present study, we describe our series of cases of giant cell tumor of bone in pediatric patients <16 years old. Methods: All cases of giant cell tumor of bone in pediatric patients <16 years old treated in our institute between 1982 and 2018 were reviewed. Immunohistochemistry and/or molecular analysis for H3F3A gene mutations was performed to confirm the diagnosis. A group of aneurysmal bone cysts in patients <16 years old was used as a control group. Results: Fifteen cases were retrieved. A pronounced female predominance (93%) was observed. A pure metaphyseal central location occurs in 2 skeletally immature patients. Conclusions: Giant cell tumor of bone should be distinguished from its mimickers due to differences in prognosis and treatment. Immunohistochemical and molecular detection of H3F3A gene mutation represents a reliable diagnostic tool.

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MRI appearances of a destructive giant cell tumor and aneurysmal bone cysts of the lumbosacral spine

International Journal of Case Reports and Images ◽

10.5348/ijcri-2012-09-184-ci-14 ◽

2012 ◽

Vol 3 ◽

pp. 1

Author(s):

Amran MY ◽

Tammasse J

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Cell Tumor ◽

Lumbosacral Spine ◽

Bone Cysts ◽

Aneurysmal Bone Cysts

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Intramuscular Tenosynovial Giant Cell Tumor Harboring a Novel CSF1-CD96 Fusion Transcript

International Journal of Surgical Pathology ◽

10.1177/10668969211049833 ◽

2021 ◽

pp. 106689692110498

Author(s):

Haider Mejbel ◽

Gene P. Siegal ◽

Shi Wei

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Gene Rearrangement ◽

Fusion Transcript ◽

Cell Tumor ◽

Molecular Profile ◽

Small Subset ◽

Fusion Partner ◽

Giant Cell Tumors ◽

Tenosynovial Giant Cell Tumor

Tenosynovial giant cell tumors typically arise in the synovium of joints, bursae, or tendon sheaths. They may occur in an intra- or extra-articular location and can be divided into localized and diffuse types. The neoplastic nature of the lesion has been supported by a recurrent CSF1 gene rearrangement in a small subset of lesional cells, of which the most common fusion partner is COL6A3. Herein, we report a case of intramuscular localized tenosynovial giant cell tumor harboring a novel CSF1-CD96 fusion transcript, thus expanding the molecular profile of this tumor.

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Correlation between Campanacci’s radiological classification of giant cell tumor of bone and expression of Cyclin D1 and PCNA

Journal of Solid Tumors ◽

10.5430/jst.v7n1p47 ◽

2017 ◽

Vol 7 (1) ◽

pp. 47

Author(s):

Eréndira G. Estrada-Villaseñor ◽

Hidalgo Bravo Alberto ◽

C. Bandala ◽

P. De la Garza-Montano ◽

Reyes Medina Naxieli ◽

...

Keyword(s):

Cyclin D1 ◽

Giant Cell Tumor ◽

Giant Cell ◽

Descriptive Study ◽

Cell Tumor ◽

Giant Cell Tumors ◽

Radiological Classification ◽

Tumors Of Bone ◽

Made In

Giant cell tumor of bone is considered by his behavior a benign but aggressive neoplasm. The objective of our study was to determine if there is a correlation between the Campanacci’s radiological classification of giant cell tumors of bone and the expression by immunohistochemistry of Cyclin D1 and proliferation cell nuclear antibody (PCNA). A retrospective and descriptive study was made. In total, there were 27 cases. All cases showed Cyclin D1 and PCNA positivity. Rho Spearman for Campanacci and Cyclin D1 expression was 0.06 and for Campanacci and PCNA was 0.418. We conclude that there is a positive correlation between PCNA expression in giant cell tumors of Bone and the Campanacci’s radiological classification II and III, butCyclin D1 expression was no related with radiologic features.

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