Giant Cell Tumor of the Skull associated with Paget's Disease of Bone

Abstract

A case of giant cell tumor of the skull associated with Paget's disease of bone is described and the eight previously reported cases are reviewed. The patient, a 41-year-old female, presented with a palpable mass, which had gradually enlarged over a 4-month period, in the right posterior parietal region. Physical examination revealed an elastic, nontender, nonmovable mass about 6 × 4 cm in size. Laboratory studies were negative, with the exception of elevated serum alkaline phosphatase. A skull X-ray showed cotton-wool-like lesions, which are characteristic of Paget's disease. Computed tomography demonstrated a homogeneously enhanced mass in the right posterior parietal region without intracranial extension. A bone scan with 99mTc-methylene diphosphoric acid disclosed abnormal uptake in the skull, pelvis, sacrum, and lumbar spine. A posterior parietal craniotomy was performed, and the tumor was totally removed. The tumor was not well demarcated from the bone, but there was no evidence of intracranial invasion. The pathological diagnosis was giant cell tumor (grade I to II) complicating Paget's disease. Radiation therapy was not administered postoperatively. The tumor had not recurred as of the 7-month follow-up examination.