Giant cell tumor and metacarpal fracture

Case contributed by Craig Hacking
Diagnosis probable

Presentation

Hand injury

Patient Data

Age: 30 years
Gender: Male

Undisplaced spiral fracture of the second metacarpal shaft. No other injury identified.

Incidental 1 cm ovoid well-defined lucent lesion in the distal radius with a well defined cortical margin. It has an indolent appearance and likely a giant cell tumor with a DDx of chondroblastoma and possibly an aneurysmal bone cyst.

No histologic correlation as the patient was lost to follow up.

Case Discussion

Beware satisfaction of search!

A giant cell tumor typically has four features:

  • eccentric location
  • abutting an articular cortex
  • closed physes
  • non sclerotic margin (although up to 5% may have some sclerosis 1

DDx for lucent epiphyseal lesions:

  • GCT
  • geode - need to have other signs of osteoarthritis
  • infection - should have clinical signs
  • chondroblastoma
  • ABC - occasionally epiphyseal

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