Aggressive Behavior of a Giant Cell Tumor Involving the Metacarpal Bone During Pregnancy: Case Report
- Affiliations
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- 1Department of Radiology, Kyung Hee University Medical Center, Kyung Hee University, Korea. gdluck@hitel.net
- 2Department of Radiology, Kyung Hee University at Gandong, Kyung Hee University, Korea.
- 3Department of Pathology, Kyung Hee University Medical Center, Kyung Hee University, Korea.
- 4Department of Orthopedic Surgery, Kyung Hee University Medical Center, Kyung Hee University, Korea.
- KMID: 2040821
- DOI: http://doi.org/10.3348/jksr.2011.64.5.509
Abstract
- Giant cell tumors are benign osteolytic tumors with a variable degree of aggressiveness. We report a rare case of a giant cell tumor involving the metacarpal bone, which was detected during pregnancy and showed rapid progression on a follow-up examination.
Figure
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Fig. 1 Serial radiographs of the left hand. A. Posteroanterior radiographs at 36 weeks gestation (initial study): an expansile, osteolytic mass with cortical destruction is noted in the meta-epiphysis of the left 4th metacarpal bone. B. The radiograph obtained 2 weeks after the initial film shows an increase in size of the mass and an aggressive periosteal reaction at the proximal portion of the lesion. C. The pre-operative radiograph obtained 5 weeks after the initial film reveals more extensive bone destruction with extension to the articular surface.
Fig. 2 Fat-suppressed (FS) T2-weighted (A) and FS contrast-enhanced T1-weighted (B) sagittal MR images obtained at 36 weeks gestation (along with Fig. 1A radiograph). The mass is shown as a heterogeneous intermediate-to-high signal intensity on a FS T2-weighted image, and an irregular-enhancing peripheral portion with non-enhancing in the central portion of the mass. Multiple intratumoral dark signal intensities throughout both sequences are noted. The mass extends into the intra-articular portion of the metacarpophalangeal joint and adjacent soft tissues.
Fig. 3 A sagittal reconstruction image of the computed tomogram for the pre-operative work-up (along with the Fig. 1C radiograph). A relatively well-defined, expansile osteolytic, mass without intratumoral mineralization is noted. A periosteal reaction is noted as generally very thin, curvilinear, and partly discontinuous. Note the aggressive appearance with an irregular elevated periosteum, but preservation of the adjacent cortical bone in the proximal portion of the mass.
Reference
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