Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Dadao 1095(#), 430030, Wuhan, People's Republic of China.
World J Surg Oncol. 2017 Jul 26;15(1):137. doi: 10.1186/s12957-017-1205-5.
Giant cell tumor of soft tissue (GCT-ST), which histologically resembles GCT of bone, is a rare tumor. Usually, it is located in the lower extremities and trunk. GCT-ST, occurring in mediastinum, is extremely rare.
We encountered an 18-year-old Chinese woman who had mild dull pain on the left side of back. The following chest computed tomography (CT) showed a heterogeneous mass deeply situated in the posterior mediastinum with compression of the lung and invasion of the adjacent rib. On magnetic resonance imaging (MRI), the tumor exhibited predominantly slight hyperintensity on T2-weighted images and intensely heterogeneous enhancement on contrast-enhanced T1-weighted images. The whole body bone scan showed a mildly increased radiotracer uptake in the proximal portion of the left fifth rib, suggestive of local infiltration by the tumor. Surgical resection of the tumor was performed; subsequently, the tumor was histopathologically proved as GCT-ST. Three months after the operation, the patient developed a local recurrence. A brief discussion about the radiological findings, histopathological features, clinical behavior, and a detailed review of the relevant literature are presented.
To the best of our knowledge, this is the first case about recurrent primary mediastinal GCT-ST, moreover, this is the first report to introduce the MRI findings of primary mediastinal GCT-ST. The present case highlights the ubiquitous distribution of soft tissue giant cell tumor and the importance of considering this tumor in the differential diagnosis of posterior mediastinal neoplasms. Also, a long-term follow-up is required to properly assess the malignant potential of this tumor.
软组织巨细胞瘤(GCT-ST)在组织学上类似于骨巨细胞瘤,是一种罕见的肿瘤。通常,它位于下肢和躯干。发生在纵隔的 GCT-ST 极为罕见。
我们遇到了一位 18 岁的中国女性,她的左侧背部有轻度隐痛。胸部 CT 检查结果显示,一个位于后纵隔深部的异质性肿块,压迫肺部并侵犯相邻肋骨。磁共振成像(MRI)上,肿瘤在 T2 加权图像上表现为主要轻度高信号,在对比增强 T1 加权图像上表现为强烈的异质性强化。全身骨扫描显示左侧第五肋骨近端放射性示踪剂摄取轻度增加,提示肿瘤局部浸润。行肿瘤切除术,术后肿瘤经组织病理学证实为 GCT-ST。术后 3 个月,患者出现局部复发。对影像学表现、组织病理学特征、临床行为进行了简要讨论,并对相关文献进行了详细复习。
据我们所知,这是首例复发性原发性纵隔 GCT-ST 病例,也是首例报道原发性纵隔 GCT-ST 的 MRI 表现。本病例强调了软组织巨细胞瘤的广泛分布以及在鉴别诊断后纵隔肿瘤时考虑该肿瘤的重要性。还需要长期随访以正确评估该肿瘤的恶性潜能。