Clinical Scenario and Imaging with Illustrations of Giant Cell Tumor of Bone: A Retrospective Analysis.

Abstract

The giant cell tumour of the bone has a spectrum of clinical-radiological presentation. This study aims to describe this varied presentation in our institution. This retrospective study was conducted on twenty-nine pathologically labelled cases of giant cell tumours of the bone. The medical records for their clinical presentation and diagnostic imaging studies were studied and evaluated. Mean age of the patients at presentation was 35.3±12.9 years. Pain, local swelling and restricted joint function were seen in 93 %, 58.6 % and 52 % patients, respectively. The cortical breach was seen in 15 (51.7 %) and 22 (75.9 %) lesions on plain radiographs and CT images, respectively. 14(48.3 %) cases had soft tissue invasion on MRI at presentation. 26 (89.7 %) lesions were located within 1 cm from the articular cartilage. The solid tumour component was hypo to iso-intense in signal intensity in 27 (93.1 %) lesions in T1 weighted and 21 (72.4 %) in T2 weighted images. 14 (48.3 %) had hyperintense cystic areas, and fluid-fluid levels, suggestive of aneurysmal bone cysts, were seen in 4 (13.8 %) cases on T2 weighted images. Hypo-echoic nodular areas in solid tumour component, suggestive of hemosiderin deposits, were present in 3 (10.3 %) lesions on T1 and T2 weighted images. The tumour classically presents as an epiphysial-metaphyseal, eccentric, expansile, lytic lesion in a skeletally mature patient. The MRI picture is variable and the surgeon should have a sound knowledge of these variations to obtain a biopsy sample from a proper site of the lesion and to avoid misdiagnosis especially of a primary ABC.