Abstract
Multicentric giant cell tumor of the bone (MGCT) is a rare entity whose radiographic, pathological and biological features remain confusing. We retrospectively reviewed six patients (1 male, 5 female; average age, 22.33 years) treated for confirmed MGCT between 2001 and 2015. The patients' clinical information, images from radiographs (n = 14), CT (n = 13), MRI (n = 8), bone scintigraphy (n = 1) and PET-CT (n = 2), as well as histologic features, treatment and prognosis were analyzed. A total of 17 lesions were detected: 4 around the knee joint, 3 in the greater trochanter and head of the femur, 5 in the small bones of the feet, and 2 in flat bones. All these lesions occurred in an ipsilateral extremity. One patient had Paget's disease. On radiographs and CT, 12 lesions exhibited sclerotic margins or patchy sclerosis, 8 showed cortical discontinuity, and 5 showed soft tissue masses. On histopathology, 8 lesions showed signs of sarcomatous transformation and one had transformed into osteosarcoma. Ten lesions in 4 patients were initially treated with surgery, and 3 showed local recurrence. Seven lesions in 3 patients were treated with denosumab. All the patients are currently stable without metastasis. These results suggest MGCT tends to occur in uncommon sites with sclerosis. Because these lesions can be aggressive, patients should be carefully monitored for the recurrence or formation of other lesions, especially in an ipsilateral extremity.
Highlights
Giant cell tumors of the bone (GCTs) are relatively common, benign, aggressive lesions that represent approximately 20% of all benign bone tumors and approximately 5% of primary bone tumors [1]
When multiple lesions are encountered in a single case, they are defined as multicentric giant cell tumor of the bone (MGCT) [6]
This was confirmed by Dhillon, who suggested that sclerosis in MGCT correlated histopathologically with abundant reactive bone formation, indicating a fibro-osseous or bone-forming tumor [8]
Summary
Giant cell tumors of the bone (GCTs) are relatively common, benign, aggressive lesions that represent approximately 20% of all benign bone tumors and approximately 5% of primary bone tumors [1]. Based on the 2013 WHO classification of tumors of the bone and soft tissue, GCTs are classified as exhibiting intermediate (rarely metastasized) or malignant biological behavior [2] with frequent local recurrence after surgical treatment, lung metastasis, and latent malignant transformation [3]. GCT occurs as a solitary lesion at the end of a long tubular bone. When multiple lesions are encountered in a single case, they are defined as multicentric giant cell tumor of the bone (MGCT) [6]. MGCT is exceedingly unusual, occurring in less than 1% of cases of GCT [7, 8]. Surgical resection remains the mainstay of www.impactjournals.com/oncotarget
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