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Infiltrating giant cell tumor in a case of Paget's disease of bone.

Nuzzo V, Ferrara T, Zuccoli A, Brunetti-Pierri R, De Rosa R, Falchetti A, Franco R, Brunetti-Pierri N - Arch Osteoporos (2009)

Bottom Line: Giant cell tumor (GCT) of the bone, also called osteoclastoma, is a rare complication of Paget's bone disease.We report a patient from Southern Italy who developed a GCT infiltrating the neighboring tissues.The natural history and the therapeutic outcomes of this unique complication of Paget's bone disease are presented.

View Article: PubMed Central - PubMed

ABSTRACT
Giant cell tumor (GCT) of the bone, also called osteoclastoma, is a rare complication of Paget's bone disease. We report a patient from Southern Italy who developed a GCT infiltrating the neighboring tissues. The natural history and the therapeutic outcomes of this unique complication of Paget's bone disease are presented.

No MeSH data available.


Related in: MedlinePlus

3D-CT scan of the tumor lesion showing irregular margins, with a diameter of approximately 8 cm and tightly adherent to the ileum and left ischio-pubic bones
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Fig1: 3D-CT scan of the tumor lesion showing irregular margins, with a diameter of approximately 8 cm and tightly adherent to the ileum and left ischio-pubic bones

Mentions: We report the case of a male patient from the region of Campania, a region of Southern Italy including the town of Avellino, who was first diagnosed with a polyostotic PDB at the age of 35 years. His medical history was significant for obesity, diverticulosis, benign prostatic hypertrophy, and mild hearing loss. The PDB was under control without any medical treatment until the age of 68 years when the patient developed back pain which was initially mild and localized, but it progressively worsened and extended to the lumbar and left iliac region. The pain was more severe with physical activity and was only partially relieved by NSAIDs. A slow-growing palpable mass in the left anterior abdominal region and a single episode of hematuria were also reported. He had no history of fracture. His family history was significant for his daughter who was also affected by PDB diagnosed when she was 20 years old and treated with biphosphonate. The physical examination confirmed the presence of a firm mass extending from the left iliac bone to the anterior abdominal region. The ultrasound and the abdominal–pelvic CT scan both indicated the presence of a lesion with irregular margins, with a diameter of approximately 8 cm and tightly adherent to the ileum and left ischio-pubic bones (Fig. 1). The lesion was found to infiltrate the rectum, the distal portion of the left ureter and the bladder. The X-rays of the pelvis (Fig. 2) and lower limbs showed cortical thickening and sclerosis of the multiloculated lytic lesions of the iliac bones. The cortex of the long bones of both upper and lower extremities was coarse and thickened. The bone scintigraphy showed increased uptake in multiple sites including the skull, vertebral bodies, proximal regions of the humeri, pelvic bones, and proximal femurs bilaterally (Fig. 3). His total serum alkaline phosphatase activity (1,346 IU/L; normal range, 8–300 IU/L) and bone-specific fraction (230.3 IU/L; normal range: 6-16 IU/L) were both significantly elevated. PTH (18.3 pg/ml; normal range 10–65 pg/ml), urinary deoxypyridoline (3.8 UI; normal range, 2.5–5.5 UI), osteocalcin (13.4 ng/ml; normal range, 5–18 ng/ml), 25-0HD (22.6 ng/ml; normal range, 9.2–45.2 ng/ml), ESR, and C-reactive protein were all within the normal ranges.Fig. 1


Infiltrating giant cell tumor in a case of Paget's disease of bone.

Nuzzo V, Ferrara T, Zuccoli A, Brunetti-Pierri R, De Rosa R, Falchetti A, Franco R, Brunetti-Pierri N - Arch Osteoporos (2009)

3D-CT scan of the tumor lesion showing irregular margins, with a diameter of approximately 8 cm and tightly adherent to the ileum and left ischio-pubic bones
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2836752&req=5

Fig1: 3D-CT scan of the tumor lesion showing irregular margins, with a diameter of approximately 8 cm and tightly adherent to the ileum and left ischio-pubic bones
Mentions: We report the case of a male patient from the region of Campania, a region of Southern Italy including the town of Avellino, who was first diagnosed with a polyostotic PDB at the age of 35 years. His medical history was significant for obesity, diverticulosis, benign prostatic hypertrophy, and mild hearing loss. The PDB was under control without any medical treatment until the age of 68 years when the patient developed back pain which was initially mild and localized, but it progressively worsened and extended to the lumbar and left iliac region. The pain was more severe with physical activity and was only partially relieved by NSAIDs. A slow-growing palpable mass in the left anterior abdominal region and a single episode of hematuria were also reported. He had no history of fracture. His family history was significant for his daughter who was also affected by PDB diagnosed when she was 20 years old and treated with biphosphonate. The physical examination confirmed the presence of a firm mass extending from the left iliac bone to the anterior abdominal region. The ultrasound and the abdominal–pelvic CT scan both indicated the presence of a lesion with irregular margins, with a diameter of approximately 8 cm and tightly adherent to the ileum and left ischio-pubic bones (Fig. 1). The lesion was found to infiltrate the rectum, the distal portion of the left ureter and the bladder. The X-rays of the pelvis (Fig. 2) and lower limbs showed cortical thickening and sclerosis of the multiloculated lytic lesions of the iliac bones. The cortex of the long bones of both upper and lower extremities was coarse and thickened. The bone scintigraphy showed increased uptake in multiple sites including the skull, vertebral bodies, proximal regions of the humeri, pelvic bones, and proximal femurs bilaterally (Fig. 3). His total serum alkaline phosphatase activity (1,346 IU/L; normal range, 8–300 IU/L) and bone-specific fraction (230.3 IU/L; normal range: 6-16 IU/L) were both significantly elevated. PTH (18.3 pg/ml; normal range 10–65 pg/ml), urinary deoxypyridoline (3.8 UI; normal range, 2.5–5.5 UI), osteocalcin (13.4 ng/ml; normal range, 5–18 ng/ml), 25-0HD (22.6 ng/ml; normal range, 9.2–45.2 ng/ml), ESR, and C-reactive protein were all within the normal ranges.Fig. 1

Bottom Line: Giant cell tumor (GCT) of the bone, also called osteoclastoma, is a rare complication of Paget's bone disease.We report a patient from Southern Italy who developed a GCT infiltrating the neighboring tissues.The natural history and the therapeutic outcomes of this unique complication of Paget's bone disease are presented.

View Article: PubMed Central - PubMed

ABSTRACT
Giant cell tumor (GCT) of the bone, also called osteoclastoma, is a rare complication of Paget's bone disease. We report a patient from Southern Italy who developed a GCT infiltrating the neighboring tissues. The natural history and the therapeutic outcomes of this unique complication of Paget's bone disease are presented.

No MeSH data available.


Related in: MedlinePlus