Investig Magn Reson Imaging.  2018 Dec;22(4):272-276. 10.13104/imri.2018.22.4.272.

Retropharyngeal Tenosynovial Giant Cell Tumor Misdiagnosed as Oropharyngeal Cancer: a Case Report

• Jung MR
• Lee JY
• Kim SY

• KMID: 2431114
• DOI: http://doi.org/10.13104/imri.2018.22.4.272

Abstract

Extra-articular tenosynovial giant cell tumor (TS-GCT) in retropharyngeal space is a rare case. We found only two case reports in the literature, in which one was located in retropharynx or prevertebral space of the cervical spine. We describe a rare case of TS-GCT in the retropharynx, which was initially misdiagnosed as oropharyngeal cancer. Furthermore, we want to assure that extraarticular diffuse type TS-GCT should be considered in the differential diagnosis of lesions showing low signal intensity in MRI scan.

Keyword

Tenosynovial giant cell tumor; Extra-articular TS-GCT; Retropharyngeal tenosynovial giant cell tumor; Magnetic resonance imaging

MeSH Terms

Diagnosis, Differential
Giant Cell Tumors*
Giant Cells*
Magnetic Resonance Imaging
Oropharyngeal Neoplasms*
Spine

Figure

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  Fig. 1 Laryngoscopy reveals a smooth margined bulging contour mass lesion in the posterior oropharynx.

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  Fig. 2 Cervical spine CT scan bone setting axial (a), sagittal (b) and soft tissue setting with enhancement (c). (a, b) The axial/reformatted sagittal bone algorithm shows bony lytic lesion with partially very thin sclerotic margin involving C2 odontoid process and vertebral body, abutting with the inferior margin of the anterior atlantoaxial (AA) joint. (c) Sagittal contrast-enhanced CT scan shows a lytic, heterogeneously enhancing soft-tissue density mass involving the C2 extending to prevertebral space, as expected from a mass originating in the prevertebral space.

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  Fig. 3 T1 sagittal (a), T2 fat suppression sagittal (b), T1 enhancement sagittal (c) (e), axial (d). (a) Sagittal T1 weighted image shows heterogeneously intermediate signal intensity mass involving the odontoid process and vertebral body of C2 and abutting with the inferior margin of the anterior atlantoaxial (AA) joint. (b) Sagittal T2 weighted image with fat-suppression shows markedly hypointense mass. (c) T1 weighted image with contrast enhancement sagittal view, (d) axial view shows heterogeneous enhancement and no evidence of perilesional extension. (e) Enhanced T1 weighted image sagittal view shows the mass abutting with the inferior border of the atlantoaxial joint but nearly not involving the joint.

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  Fig. 4 The pathologic finding shows numerous foamy histiocytes, scattered multinucleated giant cells, consistent with diffuse type tenosynovial giant cell tumor (Hematoxylin & Eosin staining, × 200).

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