Not recommended: benign fibrous histiocytoma, osteoclastoma
Definitions
Locally aggressive, rarely metastasizing tumor of neoplastic mononuclear stromal cells with macrophages and osteoclast-like giant cells
Malignant GCTB (< 10% of cases)
Primary malignant GCTB: malignant nodule within benign GCTB
Secondary malignant GCTB: secondary to treatment of initially benign GCTB
More common than primary malignant GCTB
Almost all cases are related to radiation therapy
Dedifferentiated GCTB: malignant GCTB with sharp delineation between conventional and malignant components
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Haygood TM et al: Benign osseous tumors and tumor-like conditions. Semin Ultrasound CT MR. 42(2):150-63, 2021
Palmerini E et al: Malignancy in giant cell tumor of bone: analysis of an open-label phase 2 study of denosumab. BMC Cancer. 21(1):89, 2021
Flanagan AM et al: Giant cell tumour of bone. In Fletcher CDM et al: WHO Classification of Tumours: Tumours of Soft Tissue and Bone. IARC Press. 440-6, 2020
Luengo-Alonso G et al: Denosumab treatment for giant-cell tumor of bone: a systematic review of the literature. Arch Orthop Trauma Surg. 139(10):1339-49, 2019
Palmerini E et al: Malignancy in giant cell tumor of bone: a review of the literature. Technol Cancer Res Treat. 18:1533033819840000, 2019
Kumar R et al: Giant cell tumor of cervical spine presenting as acute asphyxia: successful surgical resection after down-staging with denosumab. Spine (Phila Pa 1976). 42(10):E629-32, 2017
Hakozaki M et al: Radiological and pathological characteristics of giant cell tumor of bone treated with denosumab. Diagn Pathol. 9:111, 2014
Mak IW et al: A translational study of the neoplastic cells of giant cell tumor of bone following neoadjuvant denosumab. J Bone Joint Surg Am. 96(15):e127, 2014
Chakarun CJ et al: Giant cell tumor of bone: review, mimics, and new developments in treatment. Radiographics. 33(1):197-211, 2013
Xu SF et al: Denosumab and giant cell tumour of bone-a review and future management considerations. Curr Oncol. 20(5):e442-7, 2013
Raskin KA et al: Giant cell tumor of bone. J Am Acad Orthop Surg. 21(2):118-26, 2013
Balke M et al: Treatment options for recurrent giant cell tumors of bone. J Cancer Res Clin Oncol. 135(1):149-58, 2009
Gebre-Medhin S et al: Telomeric associations correlate with telomere length reduction and clonal chromosome aberrations in giant cell tumor of bone. Cytogenet Genome Res. 124(2):121-7, 2009
Guo W et al: Outcome of conservative surgery for giant cell tumor of the sacrum. Spine (Phila Pa 1976). 34(10):1025-31, 2009
Kudo N et al: Expression of bone morphogenetic proteins in giant cell tumor of bone. Anticancer Res. 29(6):2219-25, 2009
Mak IW et al: Upregulation of MMP-13 via Runx2 in the stromal cell of giant cell tumor of bone. Bone. 45(2):377-86, 2009
Moskovszky L et al: Genomic instability in giant cell tumor of bone. A study of 52 cases using DNA ploidy, relocalization FISH, and array-CGH analysis. Genes Chromosomes Cancer. 48(6):468-79, 2009
Thomas DM et al: Giant cell tumour of bone. Curr Opin Oncol. 21(4):338-44, 2009
Arbeitsgemeinschaft Knochentumoren et al: Local recurrence of giant cell tumor of bone after intralesional treatment with and without adjuvant therapy. J Bone Joint Surg Am. 90(5):1060-7, 2008
Balke M et al: Giant cell tumor of bone: treatment and outcome of 214 cases. J Cancer Res Clin Oncol. 134(9):969-78, 2008
Ofluoglu O: Aggressive treatment of giant cell tumour with multiple local adjuvants. Acta Orthop Belg. 74(6):831-6, 2008
Tse LF et al: Bisphosphonates reduce local recurrence in extremity giant cell tumor of bone: a case-control study. Bone. 42(1):68-73, 2008
Hoch B et al: Giant cell tumor complicating Paget disease of long bone. Skeletal Radiol. 36(10):973-8, 2007
Puri A et al: Giant cell tumor of bone in children and adolescents. J Pediatr Orthop. 27(6):635-9, 2007
Hoch B et al: Multicentric giant cell tumor of bone. Clinicopathologic analysis of thirty cases. J Bone Joint Surg Am. 88(9):1998-2008, 2006
Reid R et al: Giant cell tumour. In Fletcher CDM et al: WHO Classification of Tumours: Tumours of Soft Tissue and Bone. IARC Press, 2002
Murphey MD et al: From the archives of AFIP. Imaging of giant cell tumor and giant cell reparative granuloma of bone: radiologic-pathologic correlation. Radiographics. 21(5):1283-309, 2001
Aoki J et al: MR findings indicative of hemosiderin in giant-cell tumor of bone: frequency, cause, and diagnostic significance. AJR Am J Roentgenol. 166(1):145-8, 1996
Tubbs WS et al: Benign giant-cell tumor of bone with pulmonary metastases: clinical findings and radiologic appearance of metastases in 13 cases. AJR Am J Roentgenol. 158(2):331-4, 1992
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Clinical Issues
TERMINOLOGY
Abbreviations
Giant cell tumor of bone (GCTB)
Synonyms
Not recommended: benign fibrous histiocytoma, osteoclastoma
Definitions
Locally aggressive, rarely metastasizing tumor of neoplastic mononuclear stromal cells with macrophages and osteoclast-like giant cells
Malignant GCTB (< 10% of cases)
Primary malignant GCTB: malignant nodule within benign GCTB
Secondary malignant GCTB: secondary to treatment of initially benign GCTB
More common than primary malignant GCTB
Almost all cases are related to radiation therapy
Dedifferentiated GCTB: malignant GCTB with sharp delineation between conventional and malignant components
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Haygood TM et al: Benign osseous tumors and tumor-like conditions. Semin Ultrasound CT MR. 42(2):150-63, 2021
Palmerini E et al: Malignancy in giant cell tumor of bone: analysis of an open-label phase 2 study of denosumab. BMC Cancer. 21(1):89, 2021
Flanagan AM et al: Giant cell tumour of bone. In Fletcher CDM et al: WHO Classification of Tumours: Tumours of Soft Tissue and Bone. IARC Press. 440-6, 2020
Luengo-Alonso G et al: Denosumab treatment for giant-cell tumor of bone: a systematic review of the literature. Arch Orthop Trauma Surg. 139(10):1339-49, 2019
Palmerini E et al: Malignancy in giant cell tumor of bone: a review of the literature. Technol Cancer Res Treat. 18:1533033819840000, 2019
Kumar R et al: Giant cell tumor of cervical spine presenting as acute asphyxia: successful surgical resection after down-staging with denosumab. Spine (Phila Pa 1976). 42(10):E629-32, 2017
Hakozaki M et al: Radiological and pathological characteristics of giant cell tumor of bone treated with denosumab. Diagn Pathol. 9:111, 2014
Mak IW et al: A translational study of the neoplastic cells of giant cell tumor of bone following neoadjuvant denosumab. J Bone Joint Surg Am. 96(15):e127, 2014
Chakarun CJ et al: Giant cell tumor of bone: review, mimics, and new developments in treatment. Radiographics. 33(1):197-211, 2013
Xu SF et al: Denosumab and giant cell tumour of bone-a review and future management considerations. Curr Oncol. 20(5):e442-7, 2013
Raskin KA et al: Giant cell tumor of bone. J Am Acad Orthop Surg. 21(2):118-26, 2013
Balke M et al: Treatment options for recurrent giant cell tumors of bone. J Cancer Res Clin Oncol. 135(1):149-58, 2009
Gebre-Medhin S et al: Telomeric associations correlate with telomere length reduction and clonal chromosome aberrations in giant cell tumor of bone. Cytogenet Genome Res. 124(2):121-7, 2009
Guo W et al: Outcome of conservative surgery for giant cell tumor of the sacrum. Spine (Phila Pa 1976). 34(10):1025-31, 2009
Kudo N et al: Expression of bone morphogenetic proteins in giant cell tumor of bone. Anticancer Res. 29(6):2219-25, 2009
Mak IW et al: Upregulation of MMP-13 via Runx2 in the stromal cell of giant cell tumor of bone. Bone. 45(2):377-86, 2009
Moskovszky L et al: Genomic instability in giant cell tumor of bone. A study of 52 cases using DNA ploidy, relocalization FISH, and array-CGH analysis. Genes Chromosomes Cancer. 48(6):468-79, 2009
Thomas DM et al: Giant cell tumour of bone. Curr Opin Oncol. 21(4):338-44, 2009
Arbeitsgemeinschaft Knochentumoren et al: Local recurrence of giant cell tumor of bone after intralesional treatment with and without adjuvant therapy. J Bone Joint Surg Am. 90(5):1060-7, 2008
Balke M et al: Giant cell tumor of bone: treatment and outcome of 214 cases. J Cancer Res Clin Oncol. 134(9):969-78, 2008
Ofluoglu O: Aggressive treatment of giant cell tumour with multiple local adjuvants. Acta Orthop Belg. 74(6):831-6, 2008
Tse LF et al: Bisphosphonates reduce local recurrence in extremity giant cell tumor of bone: a case-control study. Bone. 42(1):68-73, 2008
Hoch B et al: Giant cell tumor complicating Paget disease of long bone. Skeletal Radiol. 36(10):973-8, 2007
Puri A et al: Giant cell tumor of bone in children and adolescents. J Pediatr Orthop. 27(6):635-9, 2007
Hoch B et al: Multicentric giant cell tumor of bone. Clinicopathologic analysis of thirty cases. J Bone Joint Surg Am. 88(9):1998-2008, 2006
Reid R et al: Giant cell tumour. In Fletcher CDM et al: WHO Classification of Tumours: Tumours of Soft Tissue and Bone. IARC Press, 2002
Murphey MD et al: From the archives of AFIP. Imaging of giant cell tumor and giant cell reparative granuloma of bone: radiologic-pathologic correlation. Radiographics. 21(5):1283-309, 2001
Aoki J et al: MR findings indicative of hemosiderin in giant-cell tumor of bone: frequency, cause, and diagnostic significance. AJR Am J Roentgenol. 166(1):145-8, 1996
Tubbs WS et al: Benign giant-cell tumor of bone with pulmonary metastases: clinical findings and radiologic appearance of metastases in 13 cases. AJR Am J Roentgenol. 158(2):331-4, 1992
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