Giant cell tumour of the patella

Case contributed by Dr Henry Knipe

Presentation

Knee pain and swelling.

Patient Data

Age: 25 years
Gender: Female

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. 

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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