Primary malignant giant cell tumor of the sternum.

Mohammed Imaduddin,Sambit Mohanty,Dillip Muduly,Suprava Naik,Mahesh Sultania,Madhabananda Kar,Pavithra Ayyanar,Mukund Namdev Sable

doi:10.4322/acr.2021.281

Abstract

ABSTRACTPrimary malignant giant cell tumor (PMGCT) is a diagnosis based on the presence of a high-grade sarcomatous component along with a typical benign giant cell tumor (GCT). We report the first case of PMGCT of the sternum in a 28-year-old male with painless swelling over the manubrium sterni. The differential diagnoses of PMGCT and giant cell-rich osteosarcoma were considered. Surgical resection was performed, and the reconstruction was done with a neosternum using polymethyl methacrylate and prolene mesh. At 30 months follow-up, the patient is disease-free.

Highlights

Giant cell tumor (GCT) is a benign but locally aggressive neoplasm of mesenchymal origin characterized by the proliferation of osteoclastic multinucleated giant cells in a background of mononuclear cell stroma
Secondary malignancy in giant cell tumor (SMGCT) is a metachronous sarcomatous growth occurring at the site of previously treated GCT, either by surgery or by radiotherapy.[2]
We present a case of primary malignancy of giant cell tumor (PMGCT) of the sternum, which is the first case reported in English Literature

Summary

INTRODUCTION

Giant cell tumor (GCT) is a benign but locally aggressive neoplasm of mesenchymal origin characterized by the proliferation of osteoclastic multinucleated giant cells in a background of mononuclear cell stroma. The contrast-enhanced computed tomography (Figure 1B, 1C and 1D) showed a 9.7×9.0×8.1 cm lobulated expansile lytic lesion involving the manubrium sterni and the proximal body of the sternum with large heterogeneously enhancing soft tissue component, peripheral rim of calcification, and contiguous infiltration of adjacent pectoralis major muscle. The histological examination of the biopsy showed predominantly osteoclastic giant cells, pleomorphic stromal cells, scattered bizarre cells, and many atypical mitotic figures It showed an acellular eosinophilic material in a filigree pattern resembling osteoid. A – Clinical photograph of the patient showing a lobulated swelling over the manubrium sterni; B-D – Contrast-enhanced computed tomography showing expansile lytic lesion involving manubrium sterni and proximal body of sternum with large heterogeneously enhancing soft tissue component, peripheral rim of calcification and contiguous infiltration of adjacent pectoralis major (B – Axial plane; C – Sternal 3D reconstruction; D – Coronal plane). After 30 months of follow-up, the patient is alive and disease-free

Findings

DISCUSSION

CONCLUSION