Atormac
Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 1699  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 Search
 
  
 Resource Links
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Article in PDF (1,602 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this Article
   References
   Article Figures

 Article Access Statistics
    Viewed1576    
    Printed60    
    Emailed1    
    PDF Downloaded42    
    Comments [Add]    

Recommend this journal

 


 
Table of Contents    
LETTER TO EDITOR
Year : 2013  |  Volume : 61  |  Issue : 2  |  Page : 192-193

Intracranial giant cell tumor of soft tissue: Mimicking a glioma


1 Department of Neurosurgery, SCB Medical College and Hospital, Cuttack - 753 007, Odisha, India
2 Department of Pathology, SCB Medical College and Hospital, Cuttack - 753 007, Odisha, India

Date of Submission04-Jan-2013
Date of Decision26-Jan-2013
Date of Acceptance17-Mar-2013
Date of Web Publication29-Apr-2013

Correspondence Address:
Satya Bhusan Senapati
Department of Neurosurgery, SCB Medical College and Hospital, Cuttack - 753 007, Odisha
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.111155

Rights and Permissions



How to cite this article:
Mishra SS, Senapati SB, Dhir MK, Tripathy K, Parida DK. Intracranial giant cell tumor of soft tissue: Mimicking a glioma. Neurol India 2013;61:192-3

How to cite this URL:
Mishra SS, Senapati SB, Dhir MK, Tripathy K, Parida DK. Intracranial giant cell tumor of soft tissue: Mimicking a glioma. Neurol India [serial online] 2013 [cited 2020 Feb 22];61:192-3. Available from: http://www.neurologyindia.com/text.asp?2013/61/2/192/111155


Sir,

Giant cell tumor of the soft tissue (GCT-ST), first described in 1972 by Salm and Sissons, is a rare tumor. Most of the reported tumors have been in the extremities with thigh being the most commonly reported site. [1] We report probably the first case of GCT-ST in brain with radiological features mimicking a glioma.

A 22-year-old male presented with complains of intermittent headache over left temporal area; associated with vomiting and progressive diminution of vision in both eyes of 3 months duration. He had one episode of generalized tonic clonic seizures during this period. Neurological examination revealed impaired memory, judgment, two point discrimination and graphasthesia over right side. Magnetic resonance imaging (MRI) of brain revealed a left-sided intra-axial deep-perisylvian lesion with perilesional edema and mass effect, hypointense on T1-weighted, and hyperintense on T2-weighted images. The lesion enhanced inhomogeneously on contrast administration [Figure 1]a and b. Cranial computed tomography (CT), bone window, did not show any bony lesion to suggest bony origin of the lesion [Figure 1]c. Preoperative radiological diagnosis was glioma. As tumor was over eloquent area, subtotal resection was done through middle temporal gyrus. Squash cytology showed multiple osteoclastic giant cells. Histopathological examination revealed a lesion composed of two components, background of mononuclear cells with numerous osteoclast-like giant cells [Figure 2]a. Mononuclear cells were spindle to oval cells with moderate amount of eosinophilic cytoplasm, round to oval nuclei with vesicular chromatin and inconspicuous nucleoli. Multinucleated giant cells were uniformly distributed with abundant cytoplasm; the nuclei were looking similar to the stoma component [Figure 2]b. Pleomorphism, cytological atypia, and mitotic activity were absent. There was no glial component, as conformed by negative GFAP immunohistochemically [Figure 2]c. At 6 month follow up, he is doing well with no local or systemic spread.
Figure 1:

Click here to view
Figure 2:

Click here to view


GCT-ST is an extremely rare lesion. These tumors show unpredictable behavior. Simple surgical excision gives cure in some patients whereas others develop metastasis. [2] The histological appearance closely resembles that of giant cell tumor of bone, it has been differentiated into low and high-grade forms on the basis of the atypia, pleomorphism, and mitotic activity of the mononuclear neoplastic component. [3],[4] Differential diagnoses of GCT-ST include soft tissue mesenchymal tumors that are rich in giant cells, such as nodular tenosynovitis, nodular fasciitis, malignant fibrous histiocytoma, giant cell-rich leiomyosarcoma. Review of the literature identified few cases of giant cell tumor skull with intracranial extension; in all these cases authors had found a lytic lesion in skull bone. [5] In our patient, there was no osteolytic skull lesion. These observations suggest that our patient has a primary intracerebral giant cell tumor. In patients with subtotal removal as in our patient, serial follow-up is required as there is a chance of local recurrence and distance metastasis.

 
  References Top

1.Mazhari NJ, Dhal A, Mandel AK. Giant cell tumor of soft tissue: A case report. Indian J Pathol Microbiol 2000;43:155-6.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Oliveira AM, Dei Tos AP, Fletcher CD, Nasciments AG. Primary giant cell tumor of soft tissue: A study of 22 cases. Am J Surg Pathol 2000;24:248-56.  Back to cited text no. 2
    
3.Folpe AL, Mooris RJ, Weiss SW. Soft tissue giant cell tumor of low malignant potential: A proposal for the reclassification of malignant giant cell tumor of soft parts. Mod Pathol 1992;12:894-902.  Back to cited text no. 3
    
4.O'Connell Jx, Wehrli BM, Nielsen GP, Rosenberg AE. Giant cell tumors of soft tissue: A clinicopathologic study of 18 benign and malignant tumors. Am J Surg Pathol 2000;24:386-95.  Back to cited text no. 4
    
5.Pai SB, Lalitha RM, Prasad K, Rao SG, Harish K. Giant cell tumor of the temporal bone-a case report. BMC Ear, Nose and Throat Disorders 2005;5:8.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2]



 

Top
Print this article  Email this article
   
Online since 20th March '04
Published by Wolters Kluwer - Medknow