PMC4901023_01
23-year-old woman with giant-cell tumor. A. AP radiograph shows an ill-defined, oval, lucent lesion in the proximal tibial metaphysis. B. Lateral radiograph shows that the lesion is located in the anterior tibial tubercle.
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AP and lateral radiographs of the tibia and fibula revealed an ill-defined, oval, lucent lesion in the anterior tibial tubercle measuring 2.2 x 1.1 x 1.0 cm (Figure 1).
23-year-old woman with giant-cell tumor. A. Axial T2 FS shows a lesion in the medial aspect of the anterior tibial tubercle. The intraosseous portion shows multilocular fluid-fluid levels. There is a 10-mm hole in the overlying anteromedial cortex with an exophytic component of tumor extending into the soft tissues, measuring 1.7 cm in greatest dimension. There is no periosteal or endosteal reactive bone. A small amount of surrounding marrow and soft-tissue edema is present. B. Sagittal SE TE:24 TR:2300 + contrast MRI. C. Sagittal T2 FS MRI.
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A small amount of secondary marrow and soft-tissue edema was present (Fig. 2A-C).
23-year-old woman with giant-cell tumor. Light microscopy of formalin-fixed permanent section reveals a polygonal- to histiocytic-appearing mononuclear population among sheets of giant cells with similar appearing nuclei and a syncytial distribution, such that the giant cells and mononuclear cells are difficult to distinguish from each other.
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On formalin-fixed permanent sections, the tumor was remarkable for sheets and lobules of giant cells admixed with mononuclear histiocytic- and fibroblastic-appearing cells (Fig. 3).