Characteristics of primary giant cell tumor in soft tissue on magnetic resonance imaging: A case report

Abstract

BACKGROUND Primary soft tissue giant cell tumor (GCT-ST) is rare and has relatively low malignant potential. Most reports are pathological and clinical studies, while imaging studies have only been reported in cases of adjacent bone or with atypical cystic degeneration. With regard to the findings on magnetic resonance imaging (MRI) or ultrasonography, superficial masses can be further identified based on facial edema, skin thickening, skin contact, internal hemorrhage or necrosis and lobulation of the mass. Unlike deep-seated masses, MRI features do not always provide an accurate diagnosis for benign and malignant patients with superficial soft-tissue lesions. Thus, the application of diffusion-weighted imaging (DWI) to evaluate superficial soft tissue tumors is necessary. CASE SUMMARY A 36-year-old woman who had a suspected malignant tumor in the upper limb on ultrasound and computed tomography is reported. The signal intensity of the suspected tumor was heterogeneous on plain MRI; nodular and heterogeneous enhancement was observed in the tumor with irregular shapes and blurred margins on dynamic contrast-enhanced MRI. The lesion on DWI was hyperintense with a higher mean apparent diffusion coefficient (ADC) value. Finally, a GCT-ST was confirmed by pathology. This case suggests that GCT-ST should be distinguished as a benign soft tissue mass from giant cell-rich soft tissue neoplasms or malignant tumors. CONCLUSION The MRI features of the superficial GCT-ST in the upper limb included heterogeneous signal intensity within the lesion on T2-weighted image (T2WI) and T1-weighted fat-saturation spoiled gradient recalled echo (T1 FSPGR), nodular enhancement with blurred margins, irregular shapes, and a slow-increased enhancement. DWI could be used to differentiate a benign soft tissue mass from a malignant mass by the mean ADC value and provide more radiologic-pathologic information for the diagnosis of GCT-ST. Comprehensive imaging of primary GCT-ST could help complete tumor resection, and in turn likely prolong survival after surgery.

CT and MRI findings of primary hepatic giant cell tumor of soft tissue: A case report

“…Previous studies have suggested that CT images of GCT-ST usually show a low-density tumor. MRI images mostly showed low-isointense on T1WI and hyperintense on T2WI [6], which are intensely heterogeneous enhancements on post-contrast T1WI. Internal areas without enhancement are often found due to necrosis, cystic degeneration and fibrous tissue [7].…”

Giant Cell Tumor of Soft Tissue: An Updated Review

“…Color Doppler examination may display increased vascularity [14,18]. Computed tomography (CT) shows a solid, heterogeneous, predominantly hypodense mass [8,[18][19][20][21]. Contrast-enhanced CT demonstrates heterogeneous enhancement.…”

“…Contrast-enhanced CT demonstrates heterogeneous enhancement. On magnetic resonance imaging (MRI), GCTST usually shows a solid soft tissue mass with low to intermediate signal intensity on T1-weighted images and variable signal intensity on T2-weighted images [8,14,20]. On the other hand, An et al reported one case of GCTST displaying a predominantly cystic mass [15].…”

Keratin-Positive Giant Cell-Rich Tumor: A Review and Update

“…The diameter ranges from 0.7 to 10.0 cm [35][36][37]. Using MRI, GCTST usually reveals a solid soft tissue mass with low to intermediate signal intensity on T1weighted images, variable signal intensity on T2-weighted images, and avid enhancement following contrast administration [38][39][40]. Positron emission tomography (PET) imaging demonstrates increased fluorodeoxyglucose (FDG) uptake with high standard uptake values [38].…”