Abstract:
Giant cell tumors (GCTs) are locally aggressive primary bone tumors of osteoclast-like cells. Most GCTs occur within the long bones, and primary GCTs involving the clivus are extremely rare. We present the case of an 18-year-old boy with binocular horizontal diplopia with an insidious onset who was found to have a hypointense enhancing mass involving the clivus and left side dorsum sellae on magnetic resonance images. The tumor was completely resected via an endoscopic endonasal transclival approach, and histopathologic examination via immunohistochemistry indicated a GCT. The patient\'s left abducens nerve palsy improved slightly after surgery. Because of the rarity of GCTs, there is no consensus about the definitive treatment protocol. However, we suggest that gross total resection is the treatment of choice, and denosumab plays a critical role in patients with subtotal resection.
摘要:
巨细胞瘤(GCT)是破骨细胞样细胞的局部侵袭性原发性骨肿瘤。大多数GCT发生在长骨内,和主要的GCTs涉及clivus是非常罕见的。我们介绍了一个18岁男孩的病例,该男孩患有双眼水平复视,其发病隐匿,在磁共振图像上发现具有低信号增强的肿块,涉及斜坡和左侧背囊。通过内镜经鼻内侧入路完全切除肿瘤,通过免疫组织化学进行的组织病理学检查显示为GCT。手术后患者的左外展神经麻痹略有改善。由于GCT的稀有性,对于最终的治疗方案尚无共识.然而,我们建议全切是首选的治疗方法,denosumab在次全切除患者中起着至关重要的作用。