PDF(Pubmed)
Abstract：
UNASSIGNED: Giant cell tumors of bone (GCTB) are infrequent tumors that usually impact the epiphyses of long bones and uncommonly manifest in the ribs. Herein, we report a case of asymptomatic GCTB directly invading the lung tissue.
METHODS: A 36-year-old man was referred to our emergency department with only left chest pain. Computed tomography revealed a large heterogeneous solid cystic mass in the left lung apex and amorphous calcification and distraction in the posterior part of the left fourth rib. Histological examination also exhibited that the GCTB originated from the rib. The patient underwent an en-bloc resection with no recurrence in his one-year follow-up.
UNASSIGNED: GCTB is characterized by osteoclast-like multinucleated giant cells and can exhibit aggressive local behavior. GCTB in the rib is rare, mainly found in the posterior arc. Radiographic features include lytic lesions with bone remodeling, often seen eccentrically in long bone epiphyses. Aggressive tumors may show cortical destruction and soft tissue extension. Surgery is often recommended for GCTB management, aiming for complete resection with sufficient surgical margins.
CONCLUSIONS: The absence of well-defined diagnostic criteria hinders the accurate diagnosis of GCTB, making a comprehensive assessment through radiological and histological examinations crucial. Upon physical examination, GCTB should be considered in the differential diagnosis for mediastinal lesions, regardless of their size. Furthermore, surgical removal can be taken into account as the primary treatment strategy for tumors that originate from the posterior arc of the ribs, such as GCTB.
METHODS: A 36-year-old man was referred to our emergency department with only left chest pain. Computed tomography revealed a large heterogeneous solid cystic mass in the left lung apex and amorphous calcification and distraction in the posterior part of the left fourth rib. Histological examination also exhibited that the GCTB originated from the rib. The patient underwent an en-bloc resection with no recurrence in his one-year follow-up.
UNASSIGNED: GCTB is characterized by osteoclast-like multinucleated giant cells and can exhibit aggressive local behavior. GCTB in the rib is rare, mainly found in the posterior arc. Radiographic features include lytic lesions with bone remodeling, often seen eccentrically in long bone epiphyses. Aggressive tumors may show cortical destruction and soft tissue extension. Surgery is often recommended for GCTB management, aiming for complete resection with sufficient surgical margins.
CONCLUSIONS: The absence of well-defined diagnostic criteria hinders the accurate diagnosis of GCTB, making a comprehensive assessment through radiological and histological examinations crucial. Upon physical examination, GCTB should be considered in the differential diagnosis for mediastinal lesions, regardless of their size. Furthermore, surgical removal can be taken into account as the primary treatment strategy for tumors that originate from the posterior arc of the ribs, such as GCTB.
摘要：
■骨巨细胞瘤（GCTB）是罕见的肿瘤，通常会影响长骨的骨phy，并在肋骨中不常见。在这里，我们报告一例无症状GCTB直接侵犯肺组织.
方法：一名36岁男子因左侧胸痛被转诊至急诊科。计算机断层扫描显示左肺尖部有大量异质实性囊性肿块，左第四肋骨后部有无定形钙化和牵张。组织学检查还显示GCTB起源于肋骨。患者接受了整块切除术，在一年的随访中没有复发。
■GCTB的特征是破骨细胞样多核巨细胞，可以表现出侵袭性的局部行为。肋骨中的GCTB很少见，主要见于后弧。影像学特征包括骨重塑的溶解性病变，通常在长骨骨骨上偏心。侵袭性肿瘤可表现为皮质破坏和软组织扩张。GCTB管理通常推荐手术，旨在以足够的手术切缘完全切除。
结论：缺乏明确的诊断标准阻碍了GCTB的准确诊断，通过放射学和组织学检查进行全面评估至关重要。在体检时,纵隔病变的鉴别诊断应考虑GCTB,不管他们的大小。此外，手术切除可以被考虑作为源自肋骨后弧的肿瘤的主要治疗策略。例如GCTB。
方法：一名36岁男子因左侧胸痛被转诊至急诊科。计算机断层扫描显示左肺尖部有大量异质实性囊性肿块，左第四肋骨后部有无定形钙化和牵张。组织学检查还显示GCTB起源于肋骨。患者接受了整块切除术，在一年的随访中没有复发。
■GCTB的特征是破骨细胞样多核巨细胞，可以表现出侵袭性的局部行为。肋骨中的GCTB很少见，主要见于后弧。影像学特征包括骨重塑的溶解性病变，通常在长骨骨骨上偏心。侵袭性肿瘤可表现为皮质破坏和软组织扩张。GCTB管理通常推荐手术，旨在以足够的手术切缘完全切除。
结论：缺乏明确的诊断标准阻碍了GCTB的准确诊断，通过放射学和组织学检查进行全面评估至关重要。在体检时,纵隔病变的鉴别诊断应考虑GCTB,不管他们的大小。此外，手术切除可以被考虑作为源自肋骨后弧的肿瘤的主要治疗策略。例如GCTB。
