Rateb Kochbati, Hassen Ben Ghozlen, Leila Abid, Faten Farah, Med Samir Daghfous
Department of Orthopaedic Surgery, Orthopaedic Institute of MT Kassab, Tunisia.
Department of Orthopaedic Surgery, Orthopaedic Institute of MT Kassab, Tunisia.
Int J Surg Case Rep. 2017;31:245-249. doi: 10.1016/j.ijscr.2016.12.019. Epub 2017 Jan 26.
Giant cell tumors of soft tissue (GCTs) are a relatively rare entity. It is a distinct but uncommon group of neoplasms morphologically identical to osseous giant cell tumor. The diffuse type of extra-articular GCT arising within muscle is a rare benign soft tissue tumor with a wide spectrum of clinical presentation.
This article reports a rare case of a 44-year-old woman with a mass arising from her right thigh. MRI showed only a few areas of low T2 signal in a mass that was hyper intense to muscle. Histopathology of this lesion located within the right quadriceps muscle revealed admixture of multinucleated giant cell with mononuclear cells. This patient was treated by surgical resection and followed up for recurrence.
Diffuse-type GCTs are commonly located in the periarticular soft tissues, but on rare occasions these lesions can be purely intramuscular or subcutaneous and can be challenging to diagnose. Characteristic findings include gradient echo secondary to hemosiderin deposition, and the low signal on T2.
Because extra-articular diffuse-type GCTs are rare, the differential diagnosis is challenging. The clinical outcomes of diffuse-type GCTs are unclear because of their rarity. Benign clinical course is expected if the lesion is excised adequately.
软组织巨细胞瘤(GCTs)是一种相对罕见的实体瘤。它是一组形态上与骨巨细胞瘤相同但不常见的独特肿瘤。发生于肌肉内的关节外弥漫型GCT是一种罕见的良性软组织肿瘤,临床表现多样。
本文报告了一例罕见病例,一名44岁女性右大腿出现肿块。MRI显示肿块中仅有少数低T2信号区域,肿块相对于肌肉呈高信号。位于右股四头肌内的该病变组织病理学显示多核巨细胞与单核细胞混合存在。该患者接受了手术切除并进行复发随访。
弥漫型GCT通常位于关节周围软组织,但极少数情况下这些病变可完全位于肌肉内或皮下,诊断具有挑战性。特征性表现包括因含铁血黄素沉积导致的梯度回波,以及T2加权像上的低信号。
由于关节外弥漫型GCT罕见,鉴别诊断具有挑战性。由于其罕见性,弥漫型GCT的临床结局尚不清楚。如果病变切除充分,预计临床过程为良性。