Skip to main content

Advertisement

SpringerLink
Log in

Giant cell tumors of the skull: a series of 18 cases and review of the literature

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Giant cell tumors (GCTs) are generally benign, locally aggressive lesions mostly located in the metaphysis of long bones. GCTs of the skull are rare and the majority of the cases have been presented as case reports. The authors retrospectively reported 18 patients with GCTs of the skull at a single institution from April 1994 to February 2012 and summarized the clinical, radiological, pathological characteristics and management of the disease. Meanwhile, a systematic review of 94 case reports of GCTs of the skull was performed. Headache and symptoms related to the involvement of intracranial nerves were the most common symptoms. Over 90 % of the tumors originated from sphenoid and temporal bones. On MRI, very low signal on T2-weighted images were found highly indicative of GCTs of the temporal bone. Univariate analysis revealed that extent of tumor resection and post-operative radiation therapy (RT) were prognostic factors significantly influencing the survival of the patients. We concluded that complete tumor resection is the optimal goal in treating this disease and adjuvant RT should be given once tumor residual is inevitable.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Epstein N, Whelan M, Reed D, Aleksic S (1982) Giant cell tumor of the skull: a report of two cases. Neurosurgery 11:263–267

    Article  CAS  PubMed  Google Scholar 

  2. Bertoni F, Unni KK, Beabout JW, Ebersold MJ (1992) Giant cell tumor of the skull. Cancer 70:1124–1132

    Article  CAS  PubMed  Google Scholar 

  3. Geissger JD, Siqueira EB, Ross ER (1970) Giant cell tumors of the sphenoid bone. J Neurosurg 32:665–670

    Article  CAS  PubMed  Google Scholar 

  4. Wolfe JR, Scheithauer BW, Dahlin DC (1983) Giant-cell tumor of the sphenoid bone. Review of 10 cases. J Neurosurg 59:322–327

    Article  PubMed  Google Scholar 

  5. Kinney SE, Sebek BA (1985) Rare tumors of the skull base and temporal bone. Am J Otol Suppl:135–142

  6. Motomochi M, Handa Y, Makita Y, Hashi K (1985) Giant cell tumor of the skull. Surg Neurol 23:25–30

    Article  CAS  PubMed  Google Scholar 

  7. Findlay JM, Chiasson D, Hudson AR, Chui M (1987) Giant-cell tumor of the middle cranial fossa. Case report. J Neurosurg 66:924–928

    Article  CAS  PubMed  Google Scholar 

  8. Watkins LD, Uttley D, Archer DJ, Wilkins P, Plowman N (1992) Giant cell tumors of the sphenoid bone. Neurosurgery 30:576–581

    Article  CAS  PubMed  Google Scholar 

  9. Vernet O, Ducrey N, Deruaz JP, de Tribolet N (1993) Giant cell tumor of the orbit. Neurosurgery 32:848–851

    Article  CAS  PubMed  Google Scholar 

  10. do Amaral C, Julio GL, Cardoso LA, Bueno MA (1994) Craniofacial treatment of giant-cell tumors of the sphenoid bone. J Craniofac Surg 5:254–256

    Article  PubMed  Google Scholar 

  11. Rock JP, Mahmood A, Cramer HB (1994) Giant cell tumor of the skull base. Am J Otol 15:268–272

    CAS  PubMed  Google Scholar 

  12. Silvers AR, Som PM, Brandwein M, Chong JL, Shah D (1996) The role of imaging in the diagnosis of giant cell tumor of the skull base. AJNR Am J Neuroradiol 17:1392–1395

    CAS  PubMed  Google Scholar 

  13. Weber AL, Hug EB, Muenter MW, Curtin HD (1997) Giant-cell tumors of the sphenoid bone in four children: radiological, clinical, and pathological findings. Skull Base Surg 7:163–173

    Article  CAS  PubMed  Google Scholar 

  14. Kattner KA, Stroink A, Gupta K, Fukushima T, Li C (1998) Giant cell tumor of the sphenoid bone. Skull Base Surg 8:93–97

    Article  CAS  PubMed  Google Scholar 

  15. Yamamoto M, Fukushima T, Sakamoto S, Tomonaga M (1998) Giant cell tumor of the sphenoid bone: long-term follow-up of two cases after chemotherapy. Surg Neurol 49:547–552

    Article  CAS  PubMed  Google Scholar 

  16. Sheikh M, Chisti FA, Sinan T (1999) Giant cell tumour of the temporal bone: case report and review of the literature. Australas Radiol 43:113–115

    Article  CAS  PubMed  Google Scholar 

  17. Spallone A, Flores GL, Zaldivar LO, Estupinan B (1999) Giant cell tumor (osteoclastoma) of the petrous bone: case report. Skull Base Surg 9:155–159

    Article  CAS  PubMed  Google Scholar 

  18. Lee HJ, Lum C (1999) Giant-cell tumor of the skull base. Neuroradiology 41:305–307

    Article  CAS  PubMed  Google Scholar 

  19. Sharma RR, Mahapatra AK, Pawar SJ, Sousa J, Dev EJ (2002) Craniospinal giant cell tumors: clinicoradiological analysis in a series of 11 cases. J Clin Neurosci 9:41–50

    Article  PubMed  Google Scholar 

  20. Bibas-Bonet H, Fauze RA, Lavado MG, Paez RO, Nieman J (2003) Garcin syndrome resulting from a giant cell tumor of the skull base in a child. Pediatr Neurol 28:392–395

    Article  PubMed  Google Scholar 

  21. Chan J, Gannon FH, Thompson LD (2003) Malignant giant cell tumor of the sphenoid. Ann Diagn Pathol 7:100–105

    Article  PubMed  Google Scholar 

  22. Tang JY, Wang CK, Su YC, Yang SF, Huang MY, Huang CJ (2003) MRI appearance of giant cell tumor of the lateral skull base: a case report. Clin Imaging 27:27–30

    Article  PubMed  Google Scholar 

  23. Harris AE, Beckner ME, Barnes L, Kassam A, Horowitz M (2004) Giant cell tumor of the skull: a case report and review of the literature. Surg Neurol 61:274–277

    Article  PubMed  Google Scholar 

  24. Pai SB, Lalitha RM, Prasad K, Rao SG, Harish K (2005) Giant cell tumor of the temporal bone: a case report. BMC Ear Nose Throat Disord 5:8

    Article  PubMed  Google Scholar 

  25. Zorlu F, Selek U, Soylemezoglu F, Oge K (2006) Malignant giant cell tumor of the skull base originating from clivus and sphenoid bone. J Neurooncol 76:149–152

    Article  PubMed  Google Scholar 

  26. Wang Y, Honda K, Suzuki S, Ishikawa K (2006) Giant cell tumor at the lateral skull base. Am J Otolaryngol 27:64–67

    Article  PubMed  Google Scholar 

  27. Kashiwagi N, Hirabuki N, Andou K, Yoshifumi N, Tanaka H, Morino H, Taki T, Ishikura R, Hirota S, Onishi H, Nakamura H (2006) MRI and CT findings of the giant cell tumors of the skull; five cases and a review of the literature. Eur J Radiol 58:435–443

    Article  PubMed  Google Scholar 

  28. Elder JB, Berry C, Gonzalez-Gomez I, Kreger MD, McComb JG (2007) Giant cell tumor of the skull in pediatric patients. Report of two cases. J Neurosurg 107:69–74

    PubMed  Google Scholar 

  29. Notarianni C, Abreo F, Nanda A (2008) Cranial vault metastasis of giant cell tumor. Ann Diagn Pathol 12:286–289

    Article  PubMed  Google Scholar 

  30. Matsushige T, Nakaoka M, Yahara K, Kagawa K, Miura H, Ohnuma H, Kurisu K (2008) Giant cell tumor of the temporal bone with intratumoral hemorrhage. J Clin Neurosci 15:923–927

    Article  PubMed  Google Scholar 

  31. Isaacson B, Berryhill W, Arts HA (2009) Giant-cell tumors of the temporal bone: management strategies. Skull Base 19:291–301

    Article  PubMed  Google Scholar 

  32. Company MM, Ramos R (2009) Giant cell tumor of the sphenoid. Arch Neurol 66:134–135

    Article  PubMed  Google Scholar 

  33. Karamanakos PN, Jaaskelainen JE, Alafuzoff I, Pirinen E, Vanninen R, Silvennoinen S, Sankilampi U, Immonen A (2010) Malignant giant cell tumor in the posterior fossa of a neonate. J Neurosurg Pediatr 5:277–282

    Article  PubMed  Google Scholar 

  34. Roeder F, Timke C, Zwicker F, Thieke C, Bischof M, Debus J, Huber PE (2010) Intensity modulated radiotherapy (IMRT) in benign giant cell tumors–a single institution case series and a short review of the literature. Radiat Oncol 5:18

    Article  PubMed  Google Scholar 

  35. Mendenhall WM, Zlotecki RA, Scarborough MT, Gibbs CP, Mendenhall NP (2006) Giant cell tumor of bone. Am J Clin Oncol 29:96–99

    Article  PubMed  Google Scholar 

  36. Wulling M, Engels C, Jesse N, Werner M, Delling G, Kaiser E (2001) The nature of giant cell tumor of bone. J Cancer Res Clin Oncol 127:467–474

    Article  CAS  PubMed  Google Scholar 

  37. Thomas D, Henshaw R, Skubitz K, Chawla S, Staddon A, Blay JY, Roudier M, Smith J, Ye Z, Sohn W, Dansey R, Jun S (2010) Denosumab in patients with giant-cell tumour of bone: an open-label, phase 2 study. Lancet Oncol 11:275–280

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank Jose Jasper L. Andal (Department of Pathology and Cell Biology, Columbia University in the City of New York, USA) for assistance with reviewing this manuscript.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, 200040, China

    Zhenyu Zhang, Jian Xu, Yu Yao, Danqi Chen & Ping Zhong

  2. Department of Radiology, Huashan Hospital, Fudan University, Shanghai, 200040, China

    Shuguang Chu

  3. Department of Neuropathology, Huashan Hospital, Fudan University, Shanghai, 200040, China

    Haixia Cheng

Authors
  1. Zhenyu Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jian Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yu Yao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shuguang Chu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Haixia Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Danqi Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ping Zhong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ping Zhong.

Additional information

Zhenyu Zhang and Jian Xu have contributed equally to this work.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Fig. 1

Age distribution in patients with GCTs of the skull. The majority (63.8 %) of the patients were diagnosed in their 2nd, 3rd and 4th decades of life (TIFF 919 kb)

Supplementary Fig. 2

Survival curves (Kaplan–Meier methods) in GCTs of the skull according to treatment patterns. a Overall survival (OS) was significantly influenced by treatment patterns (p = 0.012). Patients underwent subtotal removal (STR) with RT had the significantly better OS than that of patients underwent STR without RT (Bonferroni correction, p = 0.017). The difference of OS between patients underwent gross total removal (GTR) with or without RT and patients underwent STR with RT did not reach statistical significance (Bonferroni correction, p = 0.416). The difference of OS between patients underwent GTR with or without RT and patients underwent STR without RT did not reach statistical significance (Bonferroni correction, p = 0.041). b Event-free survival (EFS) was significantly influenced by treatment patterns (p < 0.001). Patients underwent GTR with or without RT had the significantly better EFS than that of patients underwent STR without RT (Bonferroni correction, p < 0.001). Patients underwent STR with RT had the significantly better EFS than that of patients underwent STR without RT (Bonferroni correction, p = 0.001). The difference of EFS between patients underwent GTR with or without RT and patients underwent STR with RT did not reach statistical significance (Bonferroni correction, p = 0.097) (TIFF 1869 kb)

Supplementary material 3 (DOC 49 kb)

Supplementary material 4 (DOC 30 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zhang, Z., Xu, J., Yao, Y. et al. Giant cell tumors of the skull: a series of 18 cases and review of the literature. J Neurooncol 115, 437–444 (2013). https://doi.org/10.1007/s11060-013-1242-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-013-1242-z

Keywords

Search

Navigation