Giant cell tumor of the bone (GCTB) is a benign bone tumor where it typically presents in the long bones, mainly at the knee regions. Rarely, benign GCTB can undergo sarcomatous malignant transformation (MGCTB). We report a case of a 63-year-old lady who presented with a swelling at the right side of the neck associated with dysphagia and voice changes. A contrast-enhanced computed tomography scan revealed a large mass seen arising from the hyoid bone with local mass effect and airway compression. However, no distant metastasis was seen. Multiple biopsies performed on the patient with the histopathology reports concluded as MGCTB. The tumor was unresectable. Therefore, the patient was treated with denosumab. She showed encouraging improvement post-treatment. We are highlighting this case report in view of the rare site of the disease and the use of denosumab in unresectable tumor with good response to therapy.
Giant Cell Tumors

Omohyoid muscle syndrome (OMS) is one of the rare causes of lateral neck swelling during swallowing and it is often a worrisome observation due to the concern of malignancy and cosmetic deformity. Anatomical variation, congenital weakness, or trauma may cause incompetence of the fascial-retaining mechanism and subsequently OMS. Its prevalence is unknown as only a few cases were reported in the past and none in Malaysia. Diagnosing OMS is very challenging. Hence, imaging techniques like real time ultrasound or dynamic computed tomography can be useful in assessing the affected muscles.
Malaysia