Giant cells can also be detected in Aneurysmal bone cysts, Chondroblastoma
, Brown tumors of hyperparathyroidism, Non-ossifying fibroma and Giant cell granuloma.
Other new information relates to chondroblastoma
, osteoblastoma, and parosteal osteosarcoma, and the section on neoplasm simulators has been expanded to include conditions like neuropathic joint that may present as a neoplasm.
The proximal humerus and adjacent soft tissues are the second most likely region in the extremities to contain a neoplastic lesion; the proximal humerus is the third most common long bone (after distal femur and proximal tibia) affected by bone tumor.(3) Sixty percent to 70% of all shoulder tumors occur in the humerus.(5) Cartilaginous lesions of all types (chondroblastoma
, enchondroma, periosteal chondroma, chondrosarcoma) have a predilection for the proximal humerus; marrow cell lesions and metastatic carcinoma are the common malignant lesions.(1) Ten percent to 15% of osseous metastases are in the upper extremity,(4) and of these, 50% will occur in the proximal humerus.(2)
(CBT) is a rare, cartilage-producing bone tumor that tends to occur in the long bones of skeletally immature individuals.
Benign conditions, which are treated with some success, include giant cell tumor, chondroblastoma
, as well as avascular necrosis.
Age 0-20 years 20-50 years >50 year Osteoblastoma Non-Hodgkin's Paget's Disease Lymphoma * Osteoid Osteoma * Osteosarcoma Lymphoma Fibrous dysplasia Giant Cell Tumor * metastatic carcinoma Hodgkins Lymphoma Aneurysmal Bone Cyst Multiple Myeloma Osteochondroma * Chondroblastoma
Chondrosarcoma Ewing sarcoma Spindle cell sarcoma (eg Fibrosarcoma) * Osteosarcoma Osteomyelitis Aneurysmal Bone Cyst Chondroblastoma
Imaging differential diagnosis includes primary aneurysmal bone cyst (ABC) and chondroblastoma
. Intravenous contrast administration on MRI is helpful in distinguishing GCTB with secondary ABC from primary ABC as the presence of enhancing soft tissue component is typically present in GCTB but not in primary ABC.
[3,4] While primary ABCs are more common, they can also occur secondary to other lesions like osteoblastoma, giant cell tumour of the bone, chondroblastoma
or fibrous dysplasia.
The most common indication for reconstruction was chondrosarcoma in 18 patients, followed by osteosarcoma in 15, giant cell tumors in 15, metastasis in 6, Ewing sarcoma in 5, chondroblastoma
in 2, and others types of tumors in the remaining 9 patients.
Other lesions almost always involve the epiphysis (giant cell tumor after physeal closure (Figure 3), chondroblastoma
(13) GCRG must be differentiated from the brown tumor of hyperparathyroidism, aneurysmal bone cyst, chondroblastoma
, fibrous dysplasia, cherubism, osteosarcoma, and true giant-cell tumor.
Calcifications may be seen, particularly when the proximal humerus or femur is involved. Because of a radiographic similarity to chondroblastoma
, suspected clear cell chondrosarcomas should be biopsied to confirm radiographic diagnoses.