2. Giant cell tumour
• Also known as Osteoclastoma
• Common benign tumour
• Locally aggressive
• recurrence
3.
4. Epidemiology
• 18-23% of benign bone neoplasm
• 20-50 years of age(80%)
• Mild female predilection especially when located in spine
• Malignant transformation(M:F=3:1)
8. staging:
- stage I:
• - benign latent giant cell tumors;
• - no local aggressive activity;
- stage II:
• - benign active GCT;
• - imaging studies demonstrate alteration of the cortical bone
structure;
- stage III:
• - locally aggressive tumors;
• - imaging studies demonstrate a lytic lesion surrounding
medullary and cortical bone;
- there may be indication of tumor penetration through the
cortex into the soft tissues
9. Radiographic features
1. Closed growth plate
2. Abuts articular
surface(within 1cm
of articular surface)
3. Well defined with
non sclerotic
margins
4. eccentric
10. Plain film and CT
• Zone of transition
• No surrounding
sclerosis
• Expansile
• Periosteal reaction
• Soft tissue mass
• Pathological fracture
• No matrix
calcification/minerali
zation
11.
12.
13. MRI
T1
• Low to intermediate
solid component
• Low signal periphery
T2
• Intermediate to high
signal
• High signal in adjacent
bone marrow represent
inflammatory edema
14. a giant cell tumor presenting as an eccentric
lytic lesion in the medial epi- and metaphysis
of the distal femur. There is a small
transitional zone resulting in well-defined
borders.
Sagittal T1-weighted TSE images before and after
Gd.
The tumor extends to the subchondral bone plate
with endosteal cortical involvement.
There is inhomogeneous enhancement.
17. Differential diagnosis
• Aneurysmal bone cyst
• Giant cell rich osteosarcoma
• Chondroblastoma
• Brown tumour of hyperparathyroidism
• Monoostotic fibrous dysplasia
• Large subarticular geode
18. • There is a well-defined lytic lesion located posteriorly in the proximal epiphysis of
the tibia.
• there is some reactive sclerosis surrounding the lesion. There is no matrix
formation.
• On the coronal T2-weighted image with fat suppression the lesion has a high SI and
subtle internal ridges. There is edema of the entire epiphysis. On a sagittal T1-
weighted image there is a discrete sclerotic margin.
19.
20.
21.
22.
23. Treatment and prognosis
• Curettage and packing
• Chemotherapy
• Radiotherapy
• Monoclonal antibodies
• Local recurrence
24. 2.Aneurysmal bone cyst
• Benign
• Blood filled
• Expansile tumour like bone lesions
• Uncertain etiology
33. MRI
• Fluid-fluid levels
• Solid component
• Surrounding rim of low T1 and T2
• Focal areas of high T1 and T2
34. • The plain radiograph shows a
layered periosteal reaction and
Codman triangle in direct
relationship to an expansile lytic
lesion with a thin peripheral
bone shell.
• CT also reveals the subperiosteal
origin of the lesion with
secondary involvement of the
cortical bone.
• Axial T2-weighted image with
fatsat and contrast enhanced T1-
weighted image with fat sat show
multiple fluid-fluid levels with
rim enhancement of the cavities
filled with blood.
• This is typical for an aneurysmal
bone cyst.
35. • On the left images of an
aneurysmal or expansile
well-defined osteolytic
bone lesion in the fibula.
• The T2-weighted MR-image
shows the fluid
content and on the T1-
weighted image there is a
subtle fluid-fluid level.
38. 1 x 0.5 cm, nidus, oval lucent focus
within surrounding sclerosis is seen
involving the region of neural arch of
L5 vertebra body at its inferio
posterior aspect showing some
eccentric bony expansion. These
findings are typical of Osteoid
Osteoma
40. Comparison
Giant cell tumour Aneurysmal bone cyst
20-50 years of age <20 years
Around knee and wrist Wide spread distribution
Subarticular Rarely extend to articular surface
eccentric Central
Non sclerotic margins Thin marginal sclerosis
Ill defined margins Well defined margins
