Giant cell tumor of bone
Alerts and Notices
Synopsis
Giant cell tumor (GCT) of bone is a rare osteolytic tumor that typically arises in the skeletal bones of adolescents and young adults in their 20s, with a slight female predominance. While generally benign, its behavior is unpredictable. It is locally aggressive and most likely to occur at the epiphyses of long bones (femur, tibia). Less frequently, it can arise in the pelvis, vertebrae, and craniofacial bones. A small percentage of cases (1%-2%) may metastasize to the lung, but unlike a true metastatic malignancy, it has a favorable survival prognosis.GCT of bone is characterized by localized pain, swelling, and limited range of motion.
Management traditionally relied on curettage and bone graft, but recurrence was as high as 50%. Improved aggressive curettage, high-speed burring, and use of adjuvants and bone cement have lowered the rate of recurrence. Various types of targeted therapies, surgery, radiation therapy, and chemotherapy are in use.
Codes
ICD10CM:D48.0 – Neoplasm of uncertain behavior of bone and articular cartilage
SNOMEDCT:
697970009 – Giant cell tumor of bone
Look For
Subscription Required
Diagnostic Pearls
Subscription Required
Differential Diagnosis & Pitfalls
- Brown cell tumor of hypoparathyroidism – Histologically very similar to GCT. Blood studies consistent with hypoparathyroidism can help differentiate these.
- Aneurysmal bone cyst – May coexist with GCT.
- Telangiectatic osteosarcoma
- Chondroblastoma – Seen in the epiphyseal region of skeletally immature patients.
- Nonossifying fibroma – Usually in younger age range.
- Chondrosarcoma – Seen in older ages.
- Chondromyxoid fibroma – Seen in the metaphyseal region with a defined sclerotic margin.
Best Tests
Subscription Required
Management Pearls
Subscription Required
Therapy
Subscription Required
References
Subscription Required
Last Reviewed:02/08/2018
Last Updated:06/30/2020
Last Updated:06/30/2020
Giant cell tumor of bone