PMC6481125_01
Diagnostic AP XR. AP radiograph of the right wrist, demonstrating radiolucency within the scaphoid.
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Wrist radiographs revealed a lytic lesion of the scaphoid with a nondisplaced pathologic fracture (Figure 1), and MRI demonstrated a marrow-replacing expansile lesion with extraosseous extension and multiple fluid-fluid levels (Figures 2(a)-2(c)).
Axial T2 fat saturation (a), sagittal T2 fat saturation (b), and coronal T1 (c) MRI sequences of the right wrist, demonstrating a marrow-replacing bone lesion within the scaphoid.
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Wrist radiographs revealed a lytic lesion of the scaphoid with a nondisplaced pathologic fracture (Figure 1), and MRI demonstrated a marrow-replacing expansile lesion with extraosseous extension and multiple fluid-fluid levels (Figures 2(a)-2(c)).
(a, b) Histopathologic examination demonstrating uniformly distributed multinucleated giant cells among mononuclear stromal cells; the nuclei of the giant cells and the stromal cells appear identical.
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The lesion was curetted, electrocautery was applied to the surfaces of the defect, and it was packed with iliac crest bone autograft including a corticocancellous strut; pathology confirmed the diagnosis (Figures 3(a) and 3(b)).
AP radiograph of the right wrist, demonstrating early consolidation of the autograft without evidence of local recurrence. 4-month follow-up X-ray.
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At her 4-month follow-up, she was transitioned to a splint and began occupational therapy, and her X-rays showed early consolidation of the graft without displacement or obvious local recurrence (Figure 4).
(a-c) AP radiograph (a) and axial and coronal CT scans (b, c) of the right wrist, demonstrating increased lucency and graft resorption within the scaphoid, consistent with local recurrence of the giant-cell tumor of bone.
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Her wrist X-rays showed an interval lucency within the scaphoid, and CT scan demonstrated cystic appearance within the scaphoid and demineralized cortical rim, concerning for tumor recurrence (Figures 5(a)-5(c)).
(a, b) AP and oblique (a) and lateral (6) radiographs of the right wrist, demonstrating consolidated 4-bone carpal fusion.
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Her follow-up X-rays taken at that visit showed a well-healed fusion of the lunate to the capitate to the hamate to the triquetrum (Figures 6(a) and 6(b)).