Giant cell tumor of bone: current review of morphological, clinical, radiological, and therapeutic characteristics

Abstract

Giant cell tumor of bone accounts for about 5% of all primary bone tumors in adults and is still one of the most obscure and intensively examined tumors of bone. This largely results from the lack of uniform clinical, radiographic, histological or morphological aspects that allow prediction of recurrence. Classified by the World Health Organization as “an aggressive, potentially malignant lesion”, the giant cell tumor of bone could give lung metastases, could undergo malignant degeneration or could have multicentric localization. It usually develops in long bones but can also occur in unusual locations. The common presenting symptom is increasing pain at the tumor site. Standard treatment ranges from curettage to wide resection, with reports of varying oncological and functional results. The recurrence rate is high during the first 2-3 years after surgery regardless of pre-operative tumor stage. Herein, we discuss the morphological, clinical, radiological, and therapeutic characteristics of this pathologic entity as well as its differential diagnosis. J Clin Exp Invest 2014; 5 (3): 475-485

Keywords

• Giant cell tumor of bone, diagnosis, treatment, review.

Kemiğin dev hücreli tümörü: Morfolojik, klinik, radyolojik ve tedavi özelliklerinin gözden geçirilmesi

Öz

Kemiğin dev hücreli tümörü erişkinlerdeki tüm primer kemik tümörlerinin %5\'ini oluşturur ve kemik tümörlerinin en güç ve yoğun araştırılanıdır. Bu durum büyük ölçüde tekrarları öngörmeye izin veren tek tip klinik, radyografik, histolojik ve morfolojik özelliklerinin olmayışı nedeniyledir. Dünya Sağlık Örgütü tarafından agresif potansiyeli olan malign bir lezyon olarak sınıflandırılan kemiğin dev hücreli tümörü akciğere metastaz yapar ve malign dejenerasyon veya çok merkezli lokalizasyon gösterir. Tümör genellikle uzun kemiklerde oluşur, ancak alışılmadık lokalizasyonlarda da olabilir. Yaygın semptomu tümör bölgesindeki artan ağrıdır. Standart tedavi küretajdan geniş rezeksiyona kadar değişir ve değişik onkolojik ve fonksiyonel sonuçlar doğurur. Tümör evresine bakılmaksızın, cerrahiyi takip eden ilk 2-3 yılda tekrarlama riski yüksektir. Bu yazıda bu patolojik teşekkülün morfolojik, klinik, radyolojik ve tedavi özellikleri ile ayırıcı tanısı tartışılmıştır.

Anahtar Kelimeler

• Kemiğin dev hücreli tümörü, tanı, tedavi, derleme

Kaynakça

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