Giant cell tumour with pathological fracture

Case contributed by Dr Ian Bickle

Presentation

Pain in the right knee following a relatively trivial fall.

Patient Data

Age: 36
Gender: Male

Mildly expansile lucent lesion in the tibial metaepiphyseal region of the tibia with a narrow zone of transition.

Cortical thinning, but no destruction.

Linear lucency through the lesion in keeping with a pathological fracture.

Small joint effusion.

Expansile T1 low/STIR high signal enhancing mass centred on the distal tibial metaphysis extending into the epiphysis.

Cortical thinning and minor cortical breech on the lateral tibial aspect with the mass extending into the intracondylar notch.

No intra-lesional fluid-fluid levels.

Pathological fracture through the lesion with a small lipohaemarthrosis.

 

Case Discussion

Giant cell tumour (GCTs) of bone is a usually benign bone tumours which arises from metaphysis and typically extending into the epiphysis of the long bones.

The commonest site representing more than half of cases is around the knee, as in this case.

On plain film the lesion is typical an expansile, lucent lesion without a sclerotic rim, but with cortical thinning and uncommonly periosteal reaction.  A pathological fracture is often present at presentation.

This case was referred to an out of country of residence hospital bone centre, for further review and biopsy, the result of which is not currently known.

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Case information

rID: 41359
Case created: 28th Nov 2015
Last edited: 14th Jan 2016
Inclusion in quiz mode: Included

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