Abstract
Giant cell tumors (GCTs) mainly occur in metaphyses of long bones and are generally considered histologically benign; however, GCTs may be locally aggressive with a high rate of local recurrence and exhibit the potential for distant metastasis. Primary GCT of the clivus is extremely rare and is easily misdiagnosed and, thus, treatment remains controversial. The present report describes the case of a 22-year-old male with GCT located in the skull base originating from the clivus, with the involvement of multiple cranial nerves, which was successfully treated with transnasal transsphenoidal surgery following adjuvant radiotherapy and intravenous bisphosphonate administration. The patient remains symptom free at two years of follow-up. This report contributes to the limited literature regarding GCTs of the skull.
Highlights
Giant cell tumors (GCTs) are considered to be a locally aggressive benign tumors, known as osteoclastoma, which typically occur in the epiphyses of long bones, the distal femur, proximal tibia, distal radius and proximal humerus
The current study presents a case of GCT in the clivus presenting with abducens nerve and trigeminal nerve involvement concurrently in a 22‐year‐old male, who was treated successfully with minimally invasive surgery, adjuvant radiotherapy and intravenous bisphosphonates, and the literature regarding diagnosis, treatment and prognosis has been reviewed
GCTs exhibit the potential for distant metastasis, mostly commonly to the lung, which occurs in 4% of patients with GCT [7]
Summary
Giant cell tumors (GCTs) are considered to be a locally aggressive benign tumors, known as osteoclastoma, which typically occur in the epiphyses of long bones, the distal femur, proximal tibia, distal radius and proximal humerus. The laboratory evaluations including, complete blood count, biochemistry, analysis of tumor markers, thyroid and pituitary function tests and endocrinology examinations were normal, and the patient's medical history was noncontributory. Due to the ZHAO et al: GIANT CELL TUMOR OF THE CLIVUS. Intraoperative findings revealed a gray, soft, friable, hypervascular mass arising from the clivus and involving the sphenoid and posterior ethmoid sinuses. The patient was diagnosed with a giant cell tumor. The patient was administered three courses of intravenous zoledronate (4 mg, once a month) and radiotherapy to reduce the local recurrence caused by subtotal resection of the tumor. Follow‐up has been performed for two years, the patient is clinically asymptomatic and no evidence of recurrence or metastases has been identified by computed tomography (CT) and MRI examination (Fig. 2). GCT, giant cell tumor; AWD, alive with disease; ANED, alive with no evidence of disease; DWD, dead with disease
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