Giant cell tumor

Case contributed by Hani M. Al Salam
Diagnosis certain

Presentation

Complains of left wrist pain post trauma.

Patient Data

Age: 13 years
Gender: Female
x-ray
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Info

An expansile lucent bone lesion with narrow zone of transition arising from the metaphysis of the distal ulna bone.

mri
This study is a stack
Axial
STIR
This study is a stack
Sagittal
T1 fat sat
This study is a stack
Coronal
STIR
This study is a stack
Axial
T1
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Coronal
T1
This study is a stack
Coronal T1
C+ fat sat
This study is a stack
Sagittal
T2
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Info

And expansile bone lesion arising from the distal ulna metaphysis, which demonstrates low signal in T1 and heterogeneous signal in T2. Foci of low signal in T2 representative of hemosiderin or fibrosis. Post gadolinium acquisition demonstrates enhancement.

Bone scan

Nuclear medicine
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Increase uptake seen at the left wrist corresponds to the lesion seen in the distal ulna bone. Delayed acquisition of the left arm further demonstrates a central photopenic region (doughnut sign).

Case Discussion

Pathologically proven giant cell tumor. What is peculiar about this case is that the growth plates are still open!

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