Giant cell tumour of the patella

Case contributed by Dr Henry Knipe

Presentation

Knee pain and swelling.

Patient Data

Age: 25 years
Gender: Female
Modality: CT

Expansile lytic lesion of the patella with cortical thinning but no discrete cortical destruction. No periosteal reaction. Internal soft tissue heterogeneity but no definite extracortical extension. No joint effusion. 

Modality: MRI

Large expansile lesion affecting the patella with cortical thinning. It extends to the subarticular surface posteriorly but not into the knee joint. There are numerous fluid-fluid levels, and at the anterior aspect there is a thick area of solid tissue enhancement, with enhancing septa also present. Adjacent soft tissue oedema.

Quadriceps tendon, patellar ligament, MPFL and LPFL are normal in signal and variably insert/originate from areas of tumour, thinned cortex and residual normal patella. 

Case Discussion

There are a number of lesions that have a fluid-fluid level, most commonly aneurysmal bone cyst and giant cell tumour (also rare osteosarcoma subtypes). The enhancing soft tissue component favours this to be a giant cell tumour. 

Unfortunately, this patient has been lost to follow-up and the pathological diagnosis is not known. 

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Case Information

rID: 47614
Case created: 24th Aug 2016
Last edited: 25th Oct 2016
Inclusion in quiz mode: Included

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