Vanesa John T, Sumi Thomas, Joy Augustine
Background: Giant cell tumour (GCT) is a benign, locally aggressive tumour with a relatively high risk of local recurrence. The purpose of this study was to define histopathological features of giant cell tumour of bone with special emphasis on recurrent tumours and denosumab induced changes. Methods: This was a descriptive study conducted at the Department of Pathology, Amala Institute of Medical Sciences, Thrissur. The details of the patient were collected from histopathology reports, request forms and case sheets. A total of 50 cases of giant cell tumour of bone were studied after getting approval from the institutional research and ethical committees. Results: There were 21 males and 29 females (1 : 1.4), whose ages ranged from 11 to 61 (mean 33) years. The tumours involved the tibia (30 %), femur (20 %), radius (20 %), fibula (6 %), talus (6 %), metatarsal (6 %), ulna (2 %), metacarpals (2 %) and phalanx (8 %). Radiographically, the lesions were usually lucent, with well-defined margins. In a few cases, the bone was expanded and focally destroyed with tumour extending into adjacent soft tissue. Microscopically, the neoplasms had oval or plump, spindle-shaped mononuclear cells uniformly interspersed with multinucleated giant cells and variable degrees of mitotic activity. Follow-up information revealed that ten cases (20 %) showed recurrences. Post denosumab changes were noted in six cases. Two cases each of primary and secondary malignant GCT are described in detail. Conclusion: Giant cell tumour with recurrences should be dealt with caution. Proper radiological and treatment correlation along with extensive sampling of the lesion to be done.
