Giant cell tumor of clivus: a rare case report and review of literature

Abstract

Clival giant cell tumors (GCTs) are an extremely rare type of tumor, with only 13 cases reported to date. Despite being histologically considered benign, these tumors can be locally aggressive and have a high rate of local recurrence, as well as the potential for distant metastasis. Due to their rarity and the difficulty of treating them due to their critical location, the ideal treatment protocol for managing clival GCTs remains controversial. The present report describes a 22-year-old female who experienced ptosis on her right eye and visual disturbance for one month. Magnetic resonance imaging (MRI) revealed a large, heterogenous, lobulated mass lesion arising from the clivus, extending anteriorly and compressing the optic chiasm and optic tract, with both parasellar extension and extension into the sphenoid sinus. An endoscopic endonasal trans-sphenoidal procedure was performed to excise the lesion. Post-operative MRI revealed residual disease, so a revision surgery was done using a combined microscopic and endoscopic procedure. Following surgery, the patient was given Denosumab for one year as well as has been symptom-free for the past 18 months of follow-up. This report contributes to the limited literature on the GCTs involving the clivus.