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Spontaneous malignant transformation of conventional giant cell tumor

Skeletal Radiology volume 33, pages 169–175 (2004)Cite this article

Abstract

Spontaneous malignant transformation of conventional giant cell tumor (GCT) of bone is exceedingly rare. We report on a case of GCT of the iliac crest in a 35-year-old woman with malignant change into a high-grade osteosarcoma 10 years after the first appearance of GCT on a radiograph. Since the patient refused therapy for personal reasons the tumor remained untreated until sarcomatous transformation occurred. Image cytometry showed DNA aneuploidy and a suspiciously high 2c deviation index (2cDI) in the primary bone lesion. A thorough review of the world literature revealed only seven fully documented cases of secondary malignant GCT which matched the definition of a “sarcomatous growth that occurs at the site of a previously documented benign giant cell tumor” and not treated by radiotherapy. These cases as well as the current one suggest that a spontaneous secondary malignant GCT presents as a frankly sarcomatous tumor in the form of an osteosarcoma or malignant fibrous histiocytoma. It usually appears at sites of typical GCTs—often without any recurrent intermediate state—and is diagnosed 3 or more years after the primary bone lesion. The prognosis is poor.

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Affiliations

  1. Institute of Cytopathology, Heinrich Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany

    H. J. Grote, N. Pomjanski & A. Böcking

  2. Orthopedic Hospital Volmarstein, University of Witten/Herdecke, Hartmannstrasse 24, 58300, Wetter (Ruhr), Germany

    M. Braun

  3. Department of Pathology, Otto von Guericke University, Leipziger Strasse 44, 39120, Magdeburg, Germany

    T. Kalinski & A. Roessner

  4. Department of Pathology, Ruprecht Karls University Heidelberg, University Hospital Mannheim, Theodor-Kutzer-Ufer, 68167, Mannheim, Germany

    W. Back & U. Bleyl

Authors
  1. H. J. Grote
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  2. M. Braun
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  3. T. Kalinski
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  4. N. Pomjanski
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  5. W. Back
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  6. U. Bleyl
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  7. A. Böcking
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  8. A. Roessner
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Correspondence to H. J. Grote.

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Grote, H.J., Braun, M., Kalinski, T. et al. Spontaneous malignant transformation of conventional giant cell tumor. Skeletal Radiol 33, 169–175 (2004). https://doi.org/10.1007/s00256-003-0682-5

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  • DOI: https://doi.org/10.1007/s00256-003-0682-5

Keywords

  • Giant cell tumor
  • Malignant transformation
  • Prognosis
  • Bone
  • DNA image cytometry
  • Radiographs
  • MRI