A 15-year-old girl presented with pain and swelling on the anterior aspect of the right knee for one year. The radiological evaluation with x-rays and magnetic resonance imaging suggested a benign aggressive lesion of the right patella with a cortical breach. Core needle biopsy of the lesion revealed it to be a giant cell tumor (GCT). She was treated with total patellectomy and end-to-end repair of quadriceps to the patellar tendon. The histopathological report of the whole specimen revealed it to be a GCT with secondary aneurysmal bone cyst (ABC). After 24 months, she was asymptomatic, and there was no evidence of local recurrence or distal metastasis. An extensive review of the literature revealed only four cases of combined GCT with secondary ABC in the patella. Though rare, GCT with secondary ABC of the patella should be kept as a differential diagnosis for anterior knee pain and swelling in young patients. The diagnosis is solely based on histopathological findings. It is imperative to obtain a precise tissue diagnosis in the preoperative period to plan appropriate treatment.

Background Neuroblastic tumor (NT) is the most common extracranial solid tumor of childhood with variable outcome which again depends on risk stratification related to distinct biology of the tumor. The use of fine‐needle aspiration (FNA) material for evaluation of cytomorphological parameters and risk stratification in NTs using cytology prognostic score (PS) is limited in routine practice. Methods We reviewed 38 FNA cytology cases diagnosed as pediatric small round cell tumor between time period June 2017 to December 2019 for clinical, cytomorphological and immunohistochemical features. Results Ten out of 38 small round cell tumors were NTs. All 10 cases were further subclassified according to International Neuroblastoma Pathology Classification into undifferentiated neuroblastoma (n = 1), poorly differentiated neuroblastoma (n = 5), differentiating neuroblastoma (n = 2), and ganglioneuroblastoma (n = 2). Cytologic PS was done using the morphological criteria as described previously in literature. The patients were divided into favorable and unfavorable cytomorphological prognostic categories with a cut off scoring of 12. A score of more than 12 is associated with high risk morphology and advanced stage. All cases with PS > 12 (n‐4) (unfavorable cytomorphology) had a poor outcome compared to six patients with PS < 12 (n‐6) (favorable cytomorphology). Conclusion Aspiration cytology can be used as a first line investigation to evaluate the cytomorphological features for risk stratification and diagnosis in patients with NTs using cytological prognostic scoring system. A larger multi‐centric validation study necessitates for cytological risk stratification.

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