Chen Piaopiao, Hu Qiang, Wu Jinfeng
Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China.
Front Surg. 2022 Apr 27;9:830852. doi: 10.3389/fsurg.2022.830852. eCollection 2022.
Primary giant cell tumors of soft tissues (GCT-STs) are extremely rare soft tissue tumors located both in superficial and in deep soft tissues. Clinically, GCT-ST manifests as a slow-growing, well-defined, painless mass. We report a case of an 88-year-old female patient with upper abdominal distension, fever, and anemia. Laparoscopic exploration revealed a tumor located in the left lobe of the liver with localized rupture and hemorrhage. Postoperative pathology revealed that the tumor was composed of monocytes and osteoclast-like multinucleated giant cells, accompanied by extensive hemorrhage, necrosis, and cytologic atypia. Because mitotic cells are difficult to be detected in pathological diagnosis, combined with immunohistochemistry, the tumor was diagnosed as a giant cell tumor of soft tissue. This case report highlights the primary choice of histology and immunohistochemistry for the correct diagnosis of GCT-ST because preoperative radiological diagnosis is nonspecific and prone to mistakes.
原发性软组织巨细胞瘤(GCT-STs)是极为罕见的软组织肿瘤,可位于浅表和深部软组织。临床上,GCT-ST表现为生长缓慢、边界清晰、无痛性肿块。我们报告一例88岁女性患者,有上腹部胀满、发热和贫血症状。腹腔镜探查发现肝脏左叶有一肿瘤,伴有局部破裂和出血。术后病理显示肿瘤由单核细胞和破骨细胞样多核巨细胞组成,伴有广泛出血、坏死和细胞异型性。由于在病理诊断中难以检测到有丝分裂细胞,结合免疫组化,该肿瘤被诊断为软组织巨细胞瘤。本病例报告强调了组织学和免疫组化对于正确诊断GCT-ST的首要选择,因为术前放射学诊断不具特异性且容易出错。