Giant cell tumor - knee

Case contributed by Dr Tee Yu Jin

Presentation

Right knee pain for 6 months, gradually worsening.

Patient Data

Age: 40 years
Gender: Male
X-ray

A lucent bone lesion with narrow zone of transition in the distal metaphysis of the femur.

MRI

A well-defined lesion in the distal metaphysis and extend into the epiphysis of the right femur, which demonstrates hypointense signal in T1 and hyperintense signal in T2/STIR and enhances in the post gadolinium acquisitions. Small cystic component seen, although it does not demonstrate fluid-fluid level, a coexistence small aneurysmal bone cyst component is still possible.

This lesion has expands and has breached the posterior cortex of the distal femur. High T1/T2 signal in the popliteal vein corresponds with a venous thrombosis.

Case Discussion

Giant cell tumors of bone are relatively common benign bone tumors and typically arise from the metaphysis of long bones, extend into the epiphysis adjacent to the joint surface.
They may present insidiously with bone pain, and 80% of cases are reported between the ages of 20 and 50. Furthermore, they are also relatively frequently coexist with aneurysmal bone cysts.
It is important to carefully examine the radiograph, as an early detected and treatment may prevent complications such as a pathological fracture.

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