Department of Radiology, General Hospital Pula, Pula, Croatia.
Department of Diagnostic and Interventional Radiology, University Hospital "Dubrava", Zagreb, Croatia.
Am J Case Rep. 2021 Jul 9;22:e932130. doi: 10.12659/AJCR.932130.
BACKGROUND Giant cell tumor is a rare tumor of mesenchymal origin. According to World Health Organization classification, it is considered a benign tumor with locally aggressive characteristics and the capacity to metastasize. The tumor typically occurs in the epiphyseal regions, most often of long bones after the completion of bone growth. The disease is characterized by severe pain and swelling of the affected area. Tumor growth is expansive but relatively slow. The tumor rarely metastasizes, but when it does, the lungs are primarily affected. CASE REPORT A 28-year-old man, otherwise healthy, presented with pain in the right wrist joint, limited range of motion, and spindle-shaped thickening/swelling in the same area, which he had noticed several months earlier. After a comprehensive diagnostic evaluation (wrist X-ray, computed tomography, magnetic resonance imaging, ultrasound-guided biopsy, and histopathological analysis), he was diagnosed with giant cell tumor of the right ulna. The tumor was surgically removed with good recovery, and the patient continued to be seen thereafter in regular followup. CONCLUSIONS The wide range of benign and malignant differential diagnostic entities requires a detailed diagnostic approach and comprehensive assessment, using different radiological modalities, as was done in this case. The final diagnosis was confirmed by histopathological analysis of core biopsy material.
巨细胞瘤是一种罕见的间充质来源的肿瘤。根据世界卫生组织的分类,它被认为是一种具有局部侵袭性特征和转移能力的良性肿瘤。肿瘤通常发生在骺板区域,大多数在长骨生长完成后发生。该疾病的特征是受影响区域的严重疼痛和肿胀。肿瘤生长具有扩展性,但相对缓慢。肿瘤很少转移,但当转移时,肺部是主要受影响的部位。
一名 28 岁健康男性,出现右侧腕关节疼痛、活动范围受限,以及同一区域的梭形增厚/肿胀,他在几个月前就已经注意到了这些症状。经过全面的诊断评估(腕关节 X 光、计算机断层扫描、磁共振成像、超声引导下活检和组织病理学分析),他被诊断为右侧尺骨巨细胞瘤。肿瘤通过手术切除,恢复良好,此后患者继续定期随访。
良性和恶性的鉴别诊断实体范围广泛,需要采用不同的影像学方法进行详细的诊断方法和全面评估,就像本例中所做的那样。最终诊断通过核心活检材料的组织病理学分析得到确认。