Korean J Radiol.  2008 Oct;9(5):462-465. 10.3348/kjr.2008.9.5.462.

Giant Cell Tumor of Soft Tissue: a Case with Atypical US and MRI Findings

• An SB
• Choi JA
• Chung JH
• Oh JH
• Kang HS

• KMID: 1385406
• DOI: http://doi.org/10.3348/kjr.2008.9.5.462

Abstract

We report the case of a giant cell tumor with diffuse interstitial hemorrhaging and unusually prominent cystic components in the soft tissue of the thigh which has not been reported previously. Magnetic resonance image (MRI), showed signal intensity typical of a giant cell tumor. However, because of its conspicuous large well-circumscribed cystic components, the differential diagnoses, based on the image findings from an ultrasonography (US) and MRI, were complicated epidermoid cyst, cystic change of a neurogenic tumor, and a parasitic cyst.

Keyword

Giant cell tumors; Soft tissue neoplasms; Cysts; Hemorrhage; Ultrasonography; Magnetic resonance (MR)

MeSH Terms

Adult
Diagnosis, Differential
Female
Giant Cell Tumors/*diagnosis/pathology/surgery/ultrasonography
Humans
*Magnetic Resonance Imaging
Soft Tissue Neoplasms/*diagnosis/pathology/surgery/ultrasonography
Thigh
*Ultrasonography, Doppler

Figure

• 

  Fig. 1 23-year-old woman with giant cell tumor of soft tissue in thigh. A. Sonogram of lateral aspect of right thigh shows primary cyst with debris and hyperechoic nodule (thick arrow). Daughter cyst was located adjacent to main cyst (thin arrow) and is also seen with fluid-fluid levels within. B. Axial T1-weighted image (TR/TE, 430/20) shows cystic mass with intermediate signal intensity (arrow) adjacent to vastus lateralis muscle in subcutaneous tissue of right thigh. C. Axial T2-weighted image (TR/TE, 4039/100) shows cystic mass with low signal intensity, which comprised of two cysts (thick arrows) and solid portion (thin arrow). Note difference in signal intensity between two cysts. Nodule (arrowhead) within large cyst is well visualized. D. Contrast-enhanced T1-weighted image (TR/TE, 500/15) with fat suppression shows diffuse enhancement of cystic wall (arrow) and solid portion (arrowhead) of mass. E. Gross photograph of excised specimen revealing extensive cystic change of mass with dark-brown color. F. Histologic features of giant cell tumor showing cystic change. Cystic wall of this mass shows mixture of mononuclear spindle cells and multinucleated osteoclast-like giant cells (arrows, Hematoxylin & Eosin staining, ×100). G. Immunohistochemical staining for CD68. Tumor cells show diffuse positive reaction in multinucleated giant cells (arrows) and focally in mononuclear spindle cells (×400) for CD68.

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