Abstract
Purpose
Giant cell reparative granulomas are rare bone tumors. Although benign, these tumors are locally destructive and can be highly vascular. They seldom occur in the cranial vault. We describe a multidisciplinary approach to a case of giant cell reparative granuloma of the cranium in a 3-year-old patient.
Case report
A 3-year-old girl female referred to the pediatric neurosurgery department for evaluation of a retro-auricular mass. She had a history of recurrent otitis media with two subsequent courses of antibiotics without resolution. CT imaging revealed an expansive lesion located in the right mastoid region. Open surgical biopsy revealed a hemorrhagic tumor consistent with a giant cell reparative granuloma. Angiography identified a hypervascular tumor blush that was supplied by the occipital artery. Preoperative transcatheter embolization was performed followed by a multidisciplinary surgical resection and reconstruction. Blood loss was minimal, and the patient recovered well after surgery.
Conclusion
Preoperative endovascular embolization and a multidisciplinary intraoperative approach with primary resection and cranial vault reconstruction is an effective approach to hypervascular giant cell reparative granulomas.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Boedeker CC, Kayser G, Ridder GJ, Maier W, Schipper J (2003) Giant cell reparative granuloma of the temporal bone: a case report and review of the literature. Ear Nose Throat J 82:926–9, 933–4, 936–7
Ciappetta P, Salvati M, Bernardi C, Raco A, Di Lorenzo N (1990) Giant cell reparative granuloma of the skull base mimicking an intracranial tumor. Case report and review of the literature. Surg Neurol 33:52–56
Cohen D, Granda-Ricart MC (1993) Giant cell reparative granuloma of the base of the skull in a 4-month-old infant—CT findings. Pediatr Radiol 23:319–320
Elhammady MS, Wolfe SQ, Ashour R, Farhat H, Moftakhar R, Lieber BB, Aziz-Sultan MA (2010) Safety and efficacy of vascular tumor embolization using onyx: is angiographic devascularization sufficient? J Neurosurg 112:1039–1045
Garza-Mercado R, Cavazos E, Hernandez-Batres F (1984) Giant cell reparative granuloma of the cranial vault: exceptional bone lesion. Neurosurgery 15:228–232
Heuer GG, Jackson EM, Magge SN, Storm PB (2007) Surgical management of pediatric brain tumors. Expert Rev Anticancer Ther 7:S61–S68
Hirschl S, Katz A (1974) Giant cell reparative granuloma outside the jaw bone. Diagnostic criteria and review of the literature with the first case described in the temporal bone. Hum Pathol 5:171–181
Huvos A (1990) Bone tumors: diagnosis, treatment, and prognosis. Saunders, Philadelphia
Jaffe HL (1953) Giant cell reparative granuloma, traumatic bone cyst, and fibrous (fibro-oseous) dysplasia of the jawbones. Oral Surg Oral Med Oral Pathol 6:159–175
Katz A, Hirschl S (1974) Giant cell reparative granuloma in the temporal bone. Arch Otolaryngol 100:380–382
Menge M, Maier W, Feuerhake F, Kaminsky J, Pfeiffer J (2009) Giant cell reparative granuloma of the temporal bone. Acta Neurochir (Wien) 151:397–399
Nemoto Y, Inoue Y, Tashiro T, Mochizuki T, Katsuyama J, Hakuba A, Onoyama Y (1995) Central giant cell granuloma of the temporal bone. AJNR Am J Neuroradiol 16:982–985
Pihlblad MS, Schaefer DP (2012) Percutaneous embolization of an orbital hemangiopericytoma with onyx facilitates its surgical excision. Ophthal Plast Reconstr Surg 28:e147–e149
Santillan A, Zink W, Lavi E, Boockvar J, Gobin YP, Patsalides A (2011) Endovascular embolization of cervical hemangiopericytoma with onyx-18: case report and review of the literature. J Neurointerv Surg 3:304–307
Sharma RR, Verma A, Pawar SJ, Dev E, Devadas RV, Shiv VK, Musa MM (2002) Pediatric giant cell granuloma of the temporal bone: a case report and brief review of the literature. J Clin Neurosci 9:459–462
Souter MA, Bird PA, Worthington JP (2006) Giant cell reparative granuloma of the temporal bone treated with calcitonin. Otol Neurotol 27:999–1002
Tesluk H, Senders CW, Dublin AB (1989) Case report 562: giant cell reparative granuloma of temporal bone. Skeletal Radiol 18:599–602
Trivelato FP, Manzato LB, Rezende MT, Barroso PM, Faleiro RM, Ulhoa AC (2012) Preoperative embolization of choroid plexus papilloma with onyx via the anterior choroidal artery: technical note. Childs Nerv Syst 28:1955–1958
Wang HH, Luo CB, Guo WY, Wu HM, Lirng JF, Wong TT, Lu YH, Chang FC (2013) Preoperative embolization of hypervascular pediatric brain tumors: Evaluation of technical safety and outcome. Childs Nerv Syst
Wolfowitz BL, Schmaman A (1973) Giant cell lesions of the temporal bone. With a case report. S Afr Med J 47:1397–1399
Yoshimura J, Onda K, Tanaka R, Takahashi H (2002) Giant cell reparative granuloma of the temporal bone: neuroradiological and immunohistochemical findings. Neurol Med Chir (Tokyo) 42:510–515
Yu JL, Qu LM, Wang J, Huang HY (2010) Giant cell reparative granuloma in the temporal bone of the skull base: report of two cases. Skull Base 20:443–448
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Conley, A., Cho, B.H., Tye, G.W. et al. Giant cell reparative granuloma of the pediatric cranium: case report and review of the literature. Childs Nerv Syst 30, 521–526 (2014). https://doi.org/10.1007/s00381-013-2254-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-013-2254-x