Presentation
MR for further assessment of a lytic bone lesion on plain radiographs.
Patient Data
There is a unique well-circumscribed proximal epiphyseal-metaphyseal lesion with a thin low signal rim, with no associated cortical involvement, periosteal reaction, or soft tissue extension. It is hyperintense on PD FS sequences, hypointense on T1, and enhances avidly after gadolinium injection. It measures 35 x 26 mm on axial images.
There is no hemosiderin deposit on gradient echo images.
An intramedullary T2 hyperintensity surrounds this lesion in keeping with bone edema.
Unlike the MRI, the CT shows that the lesion is quite well-marginated but without peripheral sclerosis (Lodwick 1B). There is also mild cortical involvement.
Case Discussion
The patient had a bone biopsy and pathology revealed a giant cell tumor of bone. She was operated on and had curettage with bone cement filling of the residual cavity. The primary differential diagnosis for this patient was chondroblastoma, but the growth plate is already fused, making the diagnosis of giant cell tumor (GCT) very likely.
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