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

Bone Neoplasms ; Giant Cell Tumors ; Giant Cells ; Granuloma, Giant Cell ; Humans

Chondroblastoma is a rare benign tumor that produces giant cells and cartilage matrix. The tumor occurs in people between 10 and 25 years with slightly higher incidence in males. The condition occurs in the proximal epiphysis of the tibia and humerus, distal epiphysis of the femur, but its occurrence in the talus is relatively rare, accounting for 4% of the total number of chondroblastoma cases. Chondroblastoma is often misdiagnosed as a primary aneurysmal bone cyst, giant cell tumor, chondromyxoid, and lesion of a secondary aneurysmal bone cyst by fibrous dysplasia. The most commonly used surgical method for chondroblastoma is broad curettage with bone grafting. In general, an aneurysmal bone cyst is associated with a second degree chondroblastoma, which is approximately 20%. Chondroblastoma of the talus and secondary aneurysmal bone cysts can be misdiagnosed as primary aneurysmal bone cysts. This paper reports a case of a young male patient with chondroblastoma of the talus, which was initially misdiagnosed as an aneurysmal bone cyst with involvement of the talo-navicular joint.
Aneurysm ; Bone Cysts ; Bone Cysts, Aneurysmal ; Bone Transplantation ; Cartilage ; Chondroblastoma ; Curettage ; Epiphyses ; Femur ; Giant Cell Tumors ; Giant Cells ; Humans ; Humerus ; Incidence ; Joints ; Male ; Methods ; Talus ; Tibia

BACKGROUND: Giant-cell tumor of bone (GCTB) is a locally aggressive primary benign tumor presenting as an expansile osteolytic lesion affecting the epiphysis of long bones. Denosumab halts the osteolysis by giant cells thereby downstaging the tumor, helping in performing less morbid procedures to remove the tumor. Our aim was to report the incidence of local recurrence (LR) in patients operated following neoadjuvant denosumab, to investigate factors associated with LR following extended curettage for GCTB, and to compare the postoperative functional and oncological outcome of patients operated with and without neoadjuvant denosumab. METHODS: A total of 123 patients with a mean age of 29.6 years undergoing extended curettage for GCTB were retrospectively divided into group 1 receiving neoadjuvant denosumab and group 2 operated without denosumab. The mean follow-up period was 35 months. The perioperative characteristics and outcome were compared between the two groups and the factors for LR of GCTB were analyzed. RESULTS: The incidence of LR among patients operated after neoadjuvant denosumab therapy was 42.8% and was significantly high compared to that in patients without denosumab (p < 0.001). On multivariate logistic regression analysis, use of denosumab as a neoadjuvant was the only factor independently associated with LR following surgery (p = 0.002). Patients treated with denosumab had a lower LR-free survival rate (log-rank, p = 0.018). CONCLUSIONS: Denosumab was independently associated with increased LR following surgery for GCTB. Denosumab has to be used cautiously in patients in whom the burden of downstaging the disease outweighs the possible chance of LR.
Curettage ; Denosumab ; Epiphyses ; Follow-Up Studies ; Giant Cell Tumors ; Giant Cells ; Humans ; Incidence ; Logistic Models ; Osteolysis ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: This study reviewed the common conditions associated with displacement of inferior alveolar nerve canal. MATERIALS AND METHODS: General search engines and specialized databases including Google Scholar, Pub Med, Pub Med Central, Science Direct, and Scopus were used to find relevant studies by using keywords such as “mandibular canal”, “alveolar canal”, “inferior alveolar nerve canal”, “inferior dental canal”, “inferior mandibular canal” and “displacement”. RESULTS: About 120 articles were found, of which approximately 70 were broadly relevant to the topic. We ultimately included 37 articles that were closely related to the topic of interest. When the data were compiled, the following 8 lesions were found to have a relationship with displacement of mandibular canal: radicular/residual cysts, dentigerous cyst, odontogenic keratocyst, aneurysmal bone cyst, ameloblastoma, central giant cell granuloma, fibrous dysplasis, and cementossifying fibroma. CONCLUSION: When clinicians encounter a lesion associated with displaced mandibular canal, they should first consider these entities in the differential diagnosis. This review would help dentists make more accurate diagnoses and develop better treatment plans according to patients' radiographs.
Ameloblastoma ; Aneurysm ; Bone Cysts ; Dentigerous Cyst ; Dentists ; Diagnosis ; Diagnosis, Differential ; Fibroma ; Granuloma, Giant Cell ; Humans ; Mandibular Nerve ; Odontogenic Cysts ; Odontogenic Tumors ; Search Engine

Fibroma of the tendon sheath (FTS) was initially described in 1936 by Geschickter and Copeland as a benign firmed soft tissue tumor that is rare and less common than another soft tissue tumors, especially giant cell tumors (GCT) of the tendon sheath. The common distinct feature is a slow-growing least painful rare entity arising from the tendon or tendon sheath. FTS is detected mostly in the fingers, hands and wrists but less commonly in the foot. Very few cases of FTS have been described arising from a flexor tendon of the foot. This article describes a 51-year-old patient with FTS that developed in the extensor tendon of the foot, which is the only known FTS to form in this area. Heterogeneous low signal intensity in both the T1- and T2-weighted images was observed in magnetic resonance imaging. The lesion was excised completely by open surgery. Histologically, it showed randomly arranged, fibroblast-like spindle cells in dense fibrous tissue and had insufficient hemosiderin-laden macrophages that are typical for GCT.
Fibroma ; Fingers ; Foot ; Giant Cell Tumors ; Hand ; Humans ; Macrophages ; Magnetic Resonance Imaging ; Middle Aged ; Tendons ; Wrist

Giant cell tumor is a benign but locally aggressive tumor with common recurrence. Most cases occur around the knee joint. Giant cell tumor of the foot is rare and very few cases involving the first metatarsal have been reported. Its characteristics and treatment in adult patients remain unclear. This paper reports a case of recurrent giant cell tumor at the first metatarsal that was excised surgically and subsequently reconstructed with non-vascularized fibula graft.
Adult ; Fibula ; Foot ; Giant Cell Tumors ; Giant Cells ; Humans ; Knee Joint ; Metatarsal Bones ; Recurrence ; Transplants

OBJECTIVES: This study aimed to determine the prevalence of odontogenic cysts, tumors, and other lesions among reports in the archives of the Department of Oral and Maxillofacial Surgery at the Faculty of Dentistry affiliated with Kocaeli University collected over a four-year period.MATERIALS AND METHODS: In this retrospective study, patient records from the archive of the Department of Oral and Maxillofacial Surgery from 2014 to 2018 were reviewed. Patient demographic information (age and sex) and lesion location were recorded and analyzed.RESULTS: From a total of 475 files reviewed, odontogenic cyst was confirmed in 340 cases (71.6%), and odontogenic tumor was confirmed in 52 cases (10.9%). Regarding odontogenic cyst type, the most common was radicular cyst (216 cases), followed by dentigerous cyst (77 cases) and odontogenic keratocyst (23 cases). Among odontogenic tumors, the most frequent was odontoma (19 cases), followed by ossifying fibroma (18 cases) and ameloblastoma (9 cases). Giant cell granuloma was also reported in 35 cases.CONCLUSION: The distribution pattern of odontogenic cysts and tumors in our retrospective study is relatively similar to that reported in the literature. Complete clinical reports for final diagnosis of these lesions and routine follow-up examinations are very important for treatment.
Ameloblastoma ; Archives ; Biopsy ; Dentigerous Cyst ; Dentistry ; Diagnosis ; Fibroma, Ossifying ; Follow-Up Studies ; Granuloma, Giant Cell ; Humans ; Jaw Neoplasms ; Odontogenic Cysts ; Odontogenic Tumors ; Odontoma ; Prevalence ; Radicular Cyst ; Retrospective Studies ; Surgery, Oral

Giant cell reparative granuloma (GCRG) is a type of non-neoplastic lesion that can be rarely found in clinical practices. Due to the lack of specificity in symptoms, signs and auxiliary examinations, it is likely to be misdiagnosed, and thereby affecting the treatment and prognosis. In July 2018, a GCRG patient who was described with "4 years of hearing loss in the left ear, accompanied by 2 months of preauricular swelling" as the first symptom was admitted in our hospital. Both the HRCT and MRI scans for the temporal bone suggested the presence of tumor at the left lateral skull base, but the nature still needed further examination. Intraoperatively, the tumor was completely removed and repaired locally. Pathological examination confirmed the symptoms as GCRG. Immunohistochemistry showed the expression of CD68 and CD163 in the tumor cells. Postoperatively, the patient recovered well without complications, and had the stitches removed before being discharged on schedule.
Bone Neoplasms ; Giant Cell Tumors ; Giant Cells ; Granuloma, Giant Cell ; Humans ; Temporal Bone

Extra-articular tenosynovial giant cell tumor (TS-GCT) in retropharyngeal space is a rare case. We found only two case reports in the literature, in which one was located in retropharynx or prevertebral space of the cervical spine. We describe a rare case of TS-GCT in the retropharynx, which was initially misdiagnosed as oropharyngeal cancer. Furthermore, we want to assure that extraarticular diffuse type TS-GCT should be considered in the differential diagnosis of lesions showing low signal intensity in MRI scan.
Diagnosis, Differential ; Giant Cell Tumors ; Giant Cells ; Magnetic Resonance Imaging ; Oropharyngeal Neoplasms ; Spine