Giant cell tumor of soft tissue: a case report with emphasis on MR imaging

BackgroundGiant cell tumor of soft tissue (GCT-ST), which histologically resembles GCT of bone, is a rare tumor. Usually, it is located in the lower extremities and trunk. GCT-ST, occurring in mediastinum, is extremely rare.Case presentationWe encountered an 18-year-old Chinese woman who had mild dull pain on the left side of back. The following chest computed tomography (CT) showed a heterogeneous mass deeply situated in the posterior mediastinum with compression of the lung and invasion of the adjacent rib. On magnetic resonance imaging (MRI), the tumor exhibited predominantly slight hyperintensity on T2-weighted images and intensely heterogeneous enhancement on contrast-enhanced T1-weighted images. The whole body bone scan showed a mildly increased radiotracer uptake in the proximal portion of the left fifth rib, suggestive of local infiltration by the tumor. Surgical resection of the tumor was performed; subsequently, the tumor was histopathologically proved as GCT-ST. Three months after the operation, the patient developed a local recurrence. A brief discussion about the radiological findings, histopathological features, clinical behavior, and a detailed review of the relevant literature are presented.ConclusionsTo the best of our knowledge, this is the first case about recurrent primary mediastinal GCT-ST, moreover, this is the first report to introduce the MRI findings of primary mediastinal GCT-ST. The present case highlights the ubiquitous distribution of soft tissue giant cell tumor and the importance of considering this tumor in the differential diagnosis of posterior mediastinal neoplasms. Also, a long-term follow-up is required to properly assess the malignant potential of this tumor.

Section: Discussionmentioning

confidence: 99%

Recurrent primary mediastinal giant cell tumor of soft tissue with radiological findings: a rare case report and literature review

Peng

Xia

2017

World J Surg Onc

“…In our study, we used a conventional MRI and DWI approach to investigate two cases of soft tissue giant cell tumor in the limb. The radiologic abnormalities of all lesions were limited to soft tissue without obvious calcification or bone erosion, which are frequently observed at the periphery of the GCT-ST tumors [2][3][4][5][6][7] . In addition, all lesions on MRI presented with solid masses, and blurry boundaries on the upper and lower edges.…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, all lesions were significantly big (maximum lesion size ranged from 4.0 cm to 6.0cm) and were located in the superficial areas of extremities or trunk. This type of lesion is commonly observed in GCT-ST, but it can also be found in the deep soft tissues of head, neck and retroperitomeum region [2][3][4][5][6][7][8][9][10] . Unlike deep-seated masses, size criteria (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…Most of the existing reports are pathological and clinical studies, while the imaging aspects have only been reported in the cases of adjacent bone or with atypical cystic degeneration [2][3][4][5][6][7][8][9][10] . There is only one case report on intravoxel incoherent motion (IVIM) DWI of juxtacortical mass [2] . Therefore, this study aims to fill the gap in the current MRI knowledge of GCT-ST of the limb by using comprehensive medical imaging examinations (especially conventional MRI added with quantitative DWI).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Pilot Evaluation of Magnetic Resonance Imaging Characteristics Seen With Primary Soft Tissue Giant Cell Tumor in 2 patients

Kang

et al. 2019

Preprint

Background Primary soft tissue giant cell tumor (GCT-ST) is a rare tumor with low malignant potential. Here we reported two cases of patients with soft tissue giant cell tumor in the limb, including their clinical and imaging findings (conventional Magnetic resonance imaging (MRI) and Diffusion weighted imaging (DWI)).Methods This retrospective study included two pathology-confirmed GCT-ST patients. Plain MRI, dynamic contrast enhancement MRI (DCE-MRI), and DWI were performed with a 3.0T whole-body MR scanner before surgery. The following characteristics of lesion were recorded: signal intensity on T 1 FSPGR and T 2 WI, morphology, maximum lesion size, time intensity curve (TIC) on DCE-MRI, and apparent diffusion coefficient (ADC) value from DWI.Results The maximum lesion size ranged from 4.0 cm to 6.0 cm. Signal intensities of all lesions were heterogeneous on T 1 FSPGR and T 2 WI. Nodular enhancements were observed for all lesions with either oval or irregular shapes on MRI. All lesion margins were blurred, and internal enhancements were heterogeneous on DCE-MRI. TIC appeared with a slow increase type. Lesions on DWI (b=500s/mm 2 ) were hyperintense with an higher mean ADC value of 2.19×10 −3 mm 2 /s compared to surrounding normal soft tissue (1.03×10 −3 mm 2 /s).Conclusions DWI may be a useful tool for differentiating benign soft tissue mass from giant cell-rich soft tissue neoplasms or malignant tumors.

“…Histologically, GCT-ST lesions bear a close resemblance to their bony counterparts, giant cell tumor of bone. Most of the existing reports are pathological and clinical studies, while the imaging aspects have only been reported in the cases of adjacent bone or with atypical cystic degeneration [2][3][4][5][6][7][8][9][10][11] . With regard to MR or ultrasonography imaging features, superficial masses can be further identified based on facial edema, skin thickening, skin contact, internal hemorrhage or necrosis and lobulation of the mass [12][13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

A Pilot Evaluation of Magnetic Resonance Imaging Characteristics Seen With Primary Soft Tissue Giant Cell Tumor in 2 patients

Kang

et al. 2020

Preprint

Background: Primary soft tissue giant cell tumor (GCT-ST) is a rare tumor with low malignant potential . Here we reported two cases of patients with soft tissue giant cell tumor in the limb, including their clinical and imaging findings (conventional Magnetic resonance imaging (MRI) and Diffusion-weighted imaging (DWI)). Methods: This retrospective study included two pathology-confirmed GCT-ST patients. Plain MRI, dynamic contrast enhancement MRI (DCE-MRI), and DWI were performed with a 3.0T whole-body MR scanner before surgery. The following characteristics of lesion were recorded: signal intensity on T 1 FSPGR and T 2 WI, morphology, maximum lesion size, time-intensity curve (TIC) on DCE-MRI, and apparent diffusion coefficient (ADC) value from DWI. Results: The maximum lesion size ranged from 4.0 cm to 6.0 cm. Signal intensities of all lesions were heterogeneous on T 1 FSPGR and T 2 WI. Nodular enhancements were observed for all lesions with either oval or irregular shapes on MRI. All lesion margins were blurred, and internal enhancements were heterogeneous on DCE-MRI. TIC appeared with a slow increase in type. Lesions on DWI (b=500s/mm 2 ) were hyperintense with a higher mean ADC value of 2.19×10 −3 mm 2 /s compared to surrounding normal soft tissue (1.03×10 −3 mm 2 /s). Conclusions: MRI features of these two GCT-STs include heterogeneous signal intensity within the lesion on T 2 WI and T 1 FSPGR, nodular enhancement with blurred margins, either oval or irregular shapes, and a slow increase enhancement of TIC on DCE-MRI. DWI may be a useful tool for differentiating benign soft tissue mass from giant cell-rich soft tissue neoplasms or malignant tumors. However, these findings need to be confirmed using a higher sample study.