BACKGROUND Giant Cell carcinoma is a variant of Sarcomatoid carcinoma which occurs at a younger age and predominantly in smoker males. Metastasis and wide spread extension is common by the time of diagnosis and is associated with a poor outcome. Fine needle aspiration cytology (FNAC) has a great role in diagnosing Giant cell carcinoma which are not amenable for surgical excision and early diagnosis by FNAC will greatly influence of the survival rate as treatment can be started immediately. We report a case of Giant Cell Carcinoma diagnosed by FNAC in a 55 yrs. male who presented with lung mass in the periphery of right lower lobe associated with overlying rib destruction.

A 44 years female, labourer by occupation, presented to our hospital with complaints of abdominal lump for 5 years, recurrent pain abdomen for past 2 years, nausea and vomiting for 2 months with generalised weakness. There was no history of constipation. She is having six live children. All were full-term normal deliveries. She has undergone hysterectomy 5 years back, but detailed documents are not available for the same. Complete haemogram showed anaemia and other routine blood and biochemistry parameters were within normal limits. USG done outside revealed hypervascular and hypoechoic mass in the left lumbar region measuring 10 x 8 x 8 cm. Upper and lower endoscopy showed no mucosal lesions. Computed tomography (CT) showed a large heterogeneously enhancing soft tissue mass showing air specks in the left lumbar region abutting jejunum medially. No lymphadenopathy was noted. Surgical resection of the tumour was done, and operative finding revealed a mass measuring 10 x 10 x 9 cm arising from serosal surface of jejunal junction at the antimesenteric border. Grossly, the received specimen was a segment of gut measuring 6 cm in length and 3 cm in diameter. On cut, the mucosa was largely unremarkable. Externally, on the serosal surface, a large encapsulated and well-circumscribed tumour mass was seen measuring 9 x 9 x 7 cm. Outer surface was nodular. On cut, unilocular cyst with maximum diameter 9 cm and wall thickness 2 cm was seen. The cyst cavity was filled with necrotic material and surface was irregular. Microscopically, the overlying mucosa was unremarkable; however, tumour was pushing the mucosa focally. Tumour was composed of interlacing bundles and fascicles of oval to spindle atypical cells. These atypical cells show moderately pleomorphic nuclei, vesicular chromatin and indistinct cytoplasm. The underlying submucosa and muscularis propria was infiltrated by the tumour cells. Areas of cystic degeneration were seen.