Abstract
Giant cell tumor (GCT) of the bone is a benign tumor with a high incidence of recurrence. The majority of recurrence occurs in the bone, typically where curettage was performed previously. Soft tissue recurrence is much less common and often shows ossification at the periphery of the soft tissue mass. We report four cases of ossified soft tissue recurrence of giant cell tumor of the bone after surgery at follow-up examination using plain radiography, ultrasound, CT, and MR imagings. Imaging findings of soft tissue recurrence with peripheral or central ossification were reviewed with pathologic correlation. To the best of our knowledge, this is the first report to describe soft tissue tumor recurrence with ossification illustrated and monitored at various imaging modalities over an extended follow-up period.
This is a preview of subscription content, log in via an institution to check access.
References
Hall FM, Frank HA, Cohen RB, Ezpeleta ML. Ossified pulmonary metastases from giant cell tumor of bone. AJR Am J Roentgenol. 1976;127(6):1046–7.
Lee FY, Montgomery M, Hazan EJ, Keel SB, Mankin HJ, Kattapuram S. Recurrent giant-cell tumor presenting as a soft-tissue mass. A report of four cases. J Bone Joint Surg Am. 1999;81(5):703–7.
Kay RM, Eckardt JJ, Seeger LL, Mirra JM, Hak DJ. Pulmonary metastasis of benign giant cell tumor of bone: six histologically confirmed cases, including one of spontaneous regression. Clin Orthop Relat Res. 1994;302:219–30.
Riley Jr LH, Hartmann WH, Robinson RA. Soft-tissue recurrence of giant-cell tumor of bone after irradiation and excision. J Bone Joint Surg Am. 1967;49(2):365–8.
Tubbs WS, Brown LR, Beabout JW, Rock MG, Unni KK. Benign giant-cell tumor of bone with pulmonary metastases: clinical findings and radiologic appearance of metastases in 13 cases. AJR Am J Roentgenol. 1992;158(2):331–4.
Ueda Y, Imai K, Tsuchiya H, et al. Matrix metalloproteinase 9 (gelatinase B) is expressed in multinucleated giant cells of human giant cell tumor of bone and is associated with vascular invasion. Am J Pathol. 1996;148(2):611.
Cooper KL, Beabout JW, Dahlin DC. Giant cell tumor: ossification in soft-tissue implants. Radiology. 1984;153(3):597–602.
Ehara S, Nishida J, Abe M, Kawata Y, Saitoh H, Kattapuram SV. Ossified soft tissue recurrence of giant cell tumor of bone. Clin Imaging. 1992;16(3):168–71.
Teot LA, O’Keefe RJ, Rosier RN, O’Connell JX, Fox EJ, Hicks DG. Extraosseous primary and recurrent giant cell tumors: transforming growth factor-beta1 and -beta2 expression may explain metaplastic bone formation. Hum Pathol. 1996;27(7):625–32.
Yang Q, Wang L, Yang Z, Li X, Meng B, Li J. Soft tissue recurrence of giant cell tumor of bone: a report of two cases and literature review. Chin-Ger J Clin Oncol. 2009;8(11):642–6.
Manaster B, Doyle AJ. Giant cell tumors of bone. Radiol Clin N Am. 1993;31(2):299.
Zhen W, Yaotian H, Songjian L, Ge L, Qingliang W. Giant-cell tumour of bone. The long-term results of treatment by curettage and bone graft. J Bone Joint Surg (Br). 2004;86(2):212–6.
Turcotte RE, Wunder JS, Isler MH, et al. Giant cell tumor of long bone: a Canadian Sarcoma Group study. Clin Orthop Relat Res. 2002;397:248–58.
Resnick D, Kyriakos M, Greenway GD. Tumors and tumor-like lesions of bone: imaging and pathology of specific lesions. In: Resnick D, editor. Diagnosis of bone and joint disorders. 3rd ed. Philadelphia, Pa: Saunders, 1995. p 3628–3938.
Blackley H, Wunder J, Davis A, White L, Kandel R, Bell R. Treatment of giant-cell tumors of long bones with curettage and bone-grafting. J Bone Joint Surg. 1999;81(6):811–20.
Capanna R, Fabbri N, Bettelli G. Curettage of giant cell tumor of bone. The effect of surgical technique and adjuvants on local recurrence rate. Chir Degli Organi Mov. 1989;75(1):206.
O’Donnell RJ, Springfield DS, Motwani HK, Ready JE, Gebhardt MC, Mankin HJ. Recurrence of giant-cell tumors of the long bones after curettage and packing with cement. J Bone Joint Surg (Am Vol). 1994;76(12):1827–33.
Kattapuram S, Phillips W, Mankin H. Giant cell tumor of bone: radiographic changes following local excision and allograft replacement. Radiology. 1986;161(2):493–8.
Pettersson H, Rydholm A, Persson B. Early radiologic detection of local recurrence after curettage and acrylic cementation of giant cell tumours. Eur J Radiol. 1986;6(1):1.
Remedios D, Saifuddin A, Pringle J. Radiological and clinical recurrence of giant-cell tumour of bone after the use of cement. J Bone Joint Surg Br Vol. 1997;79(1):26–30.
James IE, Dodds RA, Olivera DL, Nuttall ME, Gowen M. Human osteoclastoma-derived stromal cells: correlation of the ability to form mineralized nodules in vitro with formation of bone in vivo. J Bone Miner Res. 1996;11(10):1453–60.
Abdel-Motaal MM, Othman AS, Katchy MK, Jassar AK. Soft-tissue recurrence of giant cell tumor of bone associated with pulmonary metastases. Gulf J Oncol. 2009;5:49–53.
McCarthy EF, Sundaram M. Heterotopic ossification: a review. Skeletal Radiol. 2005;34(10):609–19.
Glazer H, Lee J, Levitt R, et al. Radiation fibrosis: differentiation from recurrent tumor by MR imaging. Radiology. 1985;156(3):721–6.
Kim SY, Park JS, Ryu KN, Jin W, Park SY. Various tumor-mimicking lesions in the musculoskeletal system: causes and diagnostic approach. Korean J Radiol. 2011;12(2):220–31.
Conflict of interest
There are no conflicts of interest to disclose.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Park, SY., Lee, M.H., Lee, J.S. et al. Ossified soft tissue recurrence of giant cell tumor of the bone: four case reports with follow-up radiographs, CT, ultrasound, and MR images. Skeletal Radiol 43, 1457–1463 (2014). https://doi.org/10.1007/s00256-014-1898-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00256-014-1898-2