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Malignant tenosynovial giant cell tumor of the leg: a radiologic-pathologic correlation and review of the literature.

Richman DM, Bresler SC, Rosenthal MH, Howard SA - J Clin Imaging Sci (2015)

Bottom Line: Malignant tenosynovial giant cell tumor (TGCT) is a rare clinical entity that can arise as a recurrent lesion or can co-exist with a benign TGCT lesion.Malignant TGCT most commonly arises in the lower extremity and tends to be clinically aggressive, with most patients developing recurrent lesions or dying.Much of the literature describes the histopathologic features and classifies this broad group of tumors, with little description of the imaging characteristics of this disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA ; Harvard Medical School, Boston, Massachusetts, USA.

ABSTRACT
Malignant tenosynovial giant cell tumor (TGCT) is a rare clinical entity that can arise as a recurrent lesion or can co-exist with a benign TGCT lesion. Malignant TGCT most commonly arises in the lower extremity and tends to be clinically aggressive, with most patients developing recurrent lesions or dying. Much of the literature describes the histopathologic features and classifies this broad group of tumors, with little description of the imaging characteristics of this disease. We present the multimodality appearance of a case of malignant diffuse-type TGCT that recurred 2 months after resection with subsequent rapid clinical progression.

No MeSH data available.


Related in: MedlinePlus

55-year-old female who initially presented with progressive right posterior calf pain now status post right leg amputation for malignant tenosynovial giant cell tumor. Gross pathology of the amputated right lower extremity reveals a heterogeneous tumor with cystic (thick arrow) and solid (thin arrow) components extending from the popliteal fossa to the mid-calf.
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Figure 6: 55-year-old female who initially presented with progressive right posterior calf pain now status post right leg amputation for malignant tenosynovial giant cell tumor. Gross pathology of the amputated right lower extremity reveals a heterogeneous tumor with cystic (thick arrow) and solid (thin arrow) components extending from the popliteal fossa to the mid-calf.

Mentions: The right lower extremity amputation specimen, which was received 7 weeks after the initial resection, revealed a large, cystic and solid mass extending from the popliteal fossa to the mid-calf [Figure 6]. Microscopic examination showed areas of large, bizarre, and anaplastic epithelioid cells, warranting a diagnosis of malignant TGCT. This degree of cytologic atypia was not represented in the original biopsy. Atypical mitoses were also present, and the tumor showed an infiltrative pattern, with invasion of the skin, associated ulceration and necrosis, and a mitotic rate of 23 per 10 HPFs [Figure 5b]. Hemosiderin deposition and characteristic cleft-like spaces were readily apparent, along with widespread areas with relatively bland cytology, the characteristic appearance of benign diffuse-type TGCT.


Malignant tenosynovial giant cell tumor of the leg: a radiologic-pathologic correlation and review of the literature.

Richman DM, Bresler SC, Rosenthal MH, Howard SA - J Clin Imaging Sci (2015)

55-year-old female who initially presented with progressive right posterior calf pain now status post right leg amputation for malignant tenosynovial giant cell tumor. Gross pathology of the amputated right lower extremity reveals a heterogeneous tumor with cystic (thick arrow) and solid (thin arrow) components extending from the popliteal fossa to the mid-calf.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4374198&req=5

Figure 6: 55-year-old female who initially presented with progressive right posterior calf pain now status post right leg amputation for malignant tenosynovial giant cell tumor. Gross pathology of the amputated right lower extremity reveals a heterogeneous tumor with cystic (thick arrow) and solid (thin arrow) components extending from the popliteal fossa to the mid-calf.
Mentions: The right lower extremity amputation specimen, which was received 7 weeks after the initial resection, revealed a large, cystic and solid mass extending from the popliteal fossa to the mid-calf [Figure 6]. Microscopic examination showed areas of large, bizarre, and anaplastic epithelioid cells, warranting a diagnosis of malignant TGCT. This degree of cytologic atypia was not represented in the original biopsy. Atypical mitoses were also present, and the tumor showed an infiltrative pattern, with invasion of the skin, associated ulceration and necrosis, and a mitotic rate of 23 per 10 HPFs [Figure 5b]. Hemosiderin deposition and characteristic cleft-like spaces were readily apparent, along with widespread areas with relatively bland cytology, the characteristic appearance of benign diffuse-type TGCT.

Bottom Line: Malignant tenosynovial giant cell tumor (TGCT) is a rare clinical entity that can arise as a recurrent lesion or can co-exist with a benign TGCT lesion.Malignant TGCT most commonly arises in the lower extremity and tends to be clinically aggressive, with most patients developing recurrent lesions or dying.Much of the literature describes the histopathologic features and classifies this broad group of tumors, with little description of the imaging characteristics of this disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA ; Harvard Medical School, Boston, Massachusetts, USA.

ABSTRACT
Malignant tenosynovial giant cell tumor (TGCT) is a rare clinical entity that can arise as a recurrent lesion or can co-exist with a benign TGCT lesion. Malignant TGCT most commonly arises in the lower extremity and tends to be clinically aggressive, with most patients developing recurrent lesions or dying. Much of the literature describes the histopathologic features and classifies this broad group of tumors, with little description of the imaging characteristics of this disease. We present the multimodality appearance of a case of malignant diffuse-type TGCT that recurred 2 months after resection with subsequent rapid clinical progression.

No MeSH data available.


Related in: MedlinePlus