• Archives of Reconstructive Microsurgery
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• v.16 no.2
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• pp.100-107
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• 2007

Treatment of giant cell tumor of distal radius can be treated in several ways according to the aggressiveness of the tumor. But the management of giant cell tumor involving juxta-articular portion has always been a difficult problem. In some giant cell tumors with bony destruction, a wide segmental resection may be needed for preventing to recur. But a main problem is preserving of bony continuity in bony defect as well as preservation of joint function. We have attempted to overcome these problems by using a microvascular technique to transfer the fibula with peroneal vascular pedicle or anterior tibial vessel as living bone graft. From April 1984 to July 2005, we performed the reconstruction of wide bone defect after segmental resection of giant cell tumor in 14 cases, using Vascularized Fibular Graft, which occur at the distal radius. VFG with peroneal vascular pedicle was in 8 cases and anterior tibial vessel was 6 cases. Recipient artery was radial artery in all cases. Method of connection was end to end anastomosis in 11 cases, and end to side in 3 cases. An average follow-up was 6 years 6 months, average bone defect after wide segmental resection of lesion was 6.8 cm. All cases revealed good bony union in average 6.5 months, and we got the wide range of motion of wrist joint without recurrence and serious complications. Grafted bone was all alive. In functional analysis, there was good in 7 cases, fair in 4 cases and bad in 1 case. Pain was decreased in all cases but there was nearly normal joint in only 4 cases. Vascularized fibular graft around wrist joint provided good functional restoration without local recurrence.

• Imaging Science in Dentistry
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• v.51 no.2
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• pp.149-154
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• 2021

Purpose: This study aimed to investigate the computed tomography and magnetic resonance imaging features of giant cell tumors in the temporomandibular joint region to facilitate accurate diagnoses. Materials and Methods: From October 2007 to June 2020, 6 patients (2 men and 4 women) at Yonsei University Dental Hospital had histopathologically proven giant cell tumors in the temporomandibular joint. Their computed tomography and magnetic resonance imaging findings were reviewed retrospectively, and the cases were classified into 3 types based on the tumor center and growth pattern observed on the radiologic findings. Results: The age of the 6 patients ranged from 25 to 53 years. Trismus was found in 5 of the 6 cases. One case recurred. The mean size of the tumors, defined based on their greatest diameter, was 32 mm (range, 15-41 mm). The characteristic features of all cases were a heterogeneously-enhancing tumorous mass with a lobulated margin on computed tomographic images and internal multiplicity of signal intensity on T2-weighted magnetic resonance images. According to the site of origin, 3 tumors were bone-centered, 2 were soft tissue-centered, and 1 was peri-articular. Conclusion: Computed tomography and magnetic resonance imaging yielded a tripartite classification of giant cell tumors of the temporomandibular joint according to their location on imaging. This study could help clinicians in the differential diagnosis of giant cell tumors and assist in proper treatment planning for tumorous diseases of the temporomandibular joint.

• The Korean Journal of Cytopathology
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• v.19 no.1
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• pp.57-64
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• 2008

Giant cell tumor of the tendon sheath (GCTTS) is a slowly growing, benign soft tissue tumor. The tumors occur predominantly on the hands and feet. Although the clinical and histopathologic features are well-defined, only a few reports have described the cytologic appearance of this entity. A 26-year-old woman presented with a gradually developing circumscribed soft tissue mass near the proximal phalanx of her left little finger for one year. Imprint and fine needle aspiration (FNA) smears were obtained from the excisional biopsy specimen. The imprint smears were composed of predominantly singly dispersed bland mononuclear cells and several giant cells. The mononuclear cells were polygonal to round, and they showed a histiocyte-like appearance. Osteoclast-type multinucleated giant cells of various sizes were randomly scattered throughout the smears, and these cells contained 3 to 50 nuclei. Nuclear atypia and pleomorphism were absent in both the single and giant cells. Loose aggregates of hemosiderin-laden macrophages and binuclear stromal cells were also seen. The cytologic features of the FNA smears were similar with those of the imprint, Additionally, the FNA smears contained several clumps of densely collagenous stromal tissue that were seldom noted in previously reported cytologic material. The cytologic features were well-correlated with the concurrent histologic findings and the diagnosis of GCTTS was made. When the clinical and radiologic datas are integrated, the diagnosis of GCTTS can be strongly suggested, based on the pre-operative cytologic specimen.

• Journal of Microbiology and Biotechnology
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• v.11 no.5
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• pp.727-738
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• 2001

Macrophagal polykaryocytes (MPs) are terminally differentiated multinuclear macrophage cells responsible for remodeling and resorption of bone, foreign body, and tissue deposition in inflammation. MPs are encountered only in bone and cartilagenous tissues, in which they are referred to as osteoclasts, odontoclasts, in which they are referred to as osteoclasts, odontoclasts, and septoclasts. Depending on the disease, the MPs differentiate into many morphological variants that include foreign-body giant cells, Langhans-type cells, and Touton-type cells. Morphological heterogeneity of MPs could Touton-type cells. Morphological heterogeneity of MPs could reflect the giant cell formation from phenotypically different marophage precursors by the process of fusion. At present, many cytokines, adhesion/fusion molecules, and other factors of the microenvironment have been discovered that influence the multinucleation process. Many evidences suggest that conditions in giant cell fibrohistiocytomas, which facilitate MP formation, are similar to the inflammation site of granulomatosis. MPs in the giant cell tumors and granulomatosis foci are formed in response to the factors secreted by mesenchymal cells. It is proposed that one of the first steps in vertebrate evolution could be the organization of skeleton remodeling, in which osteoclasts play a major role. In this step, the same mechanism of regulations served as a basis for the development of both osteoclast and inflammatory forms of MPs.

• Korean Journal of Head & Neck Oncology
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• v.35 no.2
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• pp.39-43
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• 2019

Peripheral giant cell granuloma (PGCG) is an benign non-neoplastic lesion most commonly occurring in oral cavity but extraoral PGCG is extremely rare. Recently, we experienced a case of an isolated PGCG in the parotid gland in 59-year-old man. FNAB findings and radiologic findings including CT and US were suggestive of Warthin's tumor. Partial parotidectomy was performed. Pathologic findings showed fibrillar connective tissue stroma with spindled, ovoid, and round histiocytes-like cells mixed with uneven multinuclear giant cells, small capillaries, hemorrhage, hemosiderin-laden macrophages, and necrosis which were consistent with giant cell granuloma. We report a case of an PGCG in parotid with a review of literature.

• The Korean Journal of Cytopathology
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• v.18 no.1
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• pp.69-73
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• 2007

Mammary carcinoma with osteoclast-like giant cells is an unusual neoplasm characterized by giant cells, mononuclear stromal cells, and hemorrhage accompanying a low grade carcinoma. We present the cytological findings in a case of invasive ductal carcinoma with osteoclast-like giant cells that was initially confused with a fibroadenoma, due to its well-demarcated and soft mass and the young age of the patient. A 28-year-old female presented with a 4.5 cm, well demarcated, soft and nontender mass in the right breast. Fine needle aspiration cytology (FNAC) showed a combination of low grade malignant epithelial cell clusters and osteoclast-like giant cells. The atypical epithelial cells were present in cohesive sheets and clusters. Osteoclast-like giant cells and bland-looking mononuclear cells were scattered. An histological examination revealed the presence of an invasive ductal carcinoma with osteoclast-like giant cells. We report here the cytological findings of this rare carcinoma in a very young woman. The minimal atypia of the epithelial cells and its soft consistency may lead to a false negative diagnosis in a young woman. The recognition that osteoclastlike giant cells are rarely present in a low grade carcinoma, but not in benign lesion, can assist the physician in making a correct diagnosis.

• The Journal of the Korean bone and joint tumor society
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• v.18 no.1
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• pp.14-19
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• 2012

Purpose: We analyzed the oncologic outcome of the malignant transformed benign giant cell tumor of bone. Materials and Methods: Between January 2000 and February 2012, 5 cases were referred with suspicious malignant transformation of benign giant cell tumor. No patients underwent radiation therapy. Results: After referral, all patients received the wide excision of the tumor and its' pathologic diagnosis were osteosarcoma. As classified by the location of tumor lesion, 3 cases were located in the distal femur, 1 case was in the distal radius and 1 case was in the proximal femur. The average latent period between diagnosis of benign giant cell tumor and diagnosis of secondary malignant giant cell tumor was 49.2 months. (range, 24-126 months) The mean follow-up period was 21.6 months. There were subsequent local recurrence in 2 cases and 3 patients developed distant metastasis. All patients with lung metastasis were dead. Conclusion: Malignant transformation of benign giant cell tumor of bone can be occurred within 5 years. Therefore, when benign giant cell tumor suspicious malignant transformation, it is necessary to do more aggressive treatment.

• The Journal of the Korean dental association
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• v.9 no.4
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• pp.191-194
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• 1971

The authors have studied cytomorphologically on the gian cells appearing in the giant cell lesions which had been collected from the biopsies at the department of oral pathology, college of dentistry, Seoul National University. The results are as follows: 1. We can classify two types of giant cells and large sized giant cells which have foamy, large nuclei and prominent nucleoli, and small sized giant cells which have small, round and homogenous stained cytoplasm. 2. We can not see the phagocytosed materials, only can see the foamy microvacuoles in the cytoplasm of giant cells. 3. We can not see the mitotic figures, nore fused figures in giant cells. 4. Osteoclasts in the periphery of bone tissue reveal large and pale stained with H-E stain, giant cells on the granulation tissue and chronic inflammatory tissue reveal deeply stained with hematoxylin and prominent nuclei, but smaller than osteoclasts.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.691-694
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• 2010

Purpose: Central giant cell granuloma is a rare, benign giant cell tumor which commonly develops in areas near the teeth. It accounts for approximately less than 7% of benign tumors of the mandible. Clinically, central giant cell granuloma is classifed into aggressive and non-aggressive type, and usually requires surgical treatment. There has been no report of central giant cell granuloma in plastic surgery field of the country, and we report a case with a brief review of the diagnosis and treatment of the disease. Methods: A 23-year-old male presented with a hard, non-tender, growing mass with the size of $4.0{\times}3.0\;cm$ on mandible for several months. Computed tomography scan showed a solid mass within thinned outer cortex on mandible. The thinned outer cortex was excised with the mass and the inner cortex was partially removed burring. After the tumor removal, mandible was fixed by reconstruction plate. Results: Pathologic report showed numerous large multinucleated giant cells, diffusely distributed in a background of ovoid-to-spindle-shaped mononuclear cells. There was no evidence of recurrence after 1 year follow up. Bony defect was regenerated and we removed the reconstruction plate. Conclusion: Removal of central giant cell granuloma results in defect of outer cortex, which can be reconstructed by using reconstruction plate, autologous bone graft or bone cement. We used reconstruction plate as a conservative method to induce secondary healing of the outer cortical defect area, which resulted in normal mastication and occlusion with no recurrence.

• Archives of Reconstructive Microsurgery
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• v.11 no.1
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• pp.67-72
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• 2002

Purpose : Treatment of giant cell tumor of distal radius can be treated in several ways according to the agressiveness of the tumor. We treated 3 cases of widely involved giant cell tumor of distal radius with wide resection and proximal fibular graft and report the results with review of literatures. Material and Method : We have treated 3 cases of giant cell tumor of the distal radius since last 1990. Among 3 cases, two cases were grade III radiologically and treated by wide resection of distal radius and vascularized proximal fibular graft, and one case, grade II radiologically, treated by distal radial resection and non-vascularized proximal fibular graft. We followed up clinical results of above three cases 9 years, 12 years and 2 years. Result : In all three cases, tranplanted fibula graft showed solid union but grade III tumors recurred at 4 year and 6 year postoperatively. One of the case which recurred 4 year later was treated with secondary wide resection and wrist fusion with autogenous iliac bone graft, and didn't show any recurrent finding for these 5 years after re-operation. And another grade III, which recurred at 6th post-operative year, is under follow-up for 6 years after recur without 2nd operation. Grade II case didn't show any recurrent findings on 2 year follow-up. Conclusion : Grade III cases recurred at 4 year and 6 year follow-up. The cause of recurrence was thought to be invasion of remaining tumor cell in the soft tissue. To prevent recurrence, complete resection of primary tumor was necessary.