PMC7728104_01
(A and B) Coronal and axial T1 MRI images showing a posterior left iliac bone tumor. MRI: Magnetic resonance imaging
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F1
(A and B) Pelvic angioCT indicating the tumoral vascularization and the nutrient vessels of the lytic lesion. CT: Computed tomography
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F2
The major arterial supplies come from superior gluteal artery and also some ilio-lumbar branches (Figure 2, A and B).
Axial pelvic CT scan indicating lytic iliac bone tumor: (A) Posterosuperior destruction of the iliac bone; (B) Good posteroinferior bone stock of the iliac bone at the sacroiliac border. CT: Computed tomography
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F3
Post-resection specimen
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F4
From the resection piece (Figure 4) sent to the Laboratory of Pathological Anatomy, fixed in 10% neutral buffered formalin, multiple sections were made from the areas of macroscopic interest (some parts of the piece required decalcification), which after inclusion in the paraffin were cut into the microtome (3-4 mum thick) and stained with the usual Hematoxylin-Eosin (HE).
Coronal and axial pelvic CT scan at two years postoperative showing no signs of local recurrence. CT: Computed tomography
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F5
Giant cell tumor of bone. Detail frame: mononuclear cells intricate multinuclear giant cells with the same nuclear traits in both cellular contingencies (HE staining, x400)
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F6
Postoperative histopathology established the diagnosis of GCT of the iliac bone, with the morphological picture characteristic of this lesion: tumor proliferation combining two complex cellular contingencies, represented by benign, oval or discreet mononuclear tumor cells and numerous multinuclear giant cells of the large osteoclastic type, evenly distributed among the mononuclear cells and displaying the same nuclear traits with these (Figures 6 and 7).
Giant cell tumor of bone. Discrete fusiform mononuclear cells among multi-nucleated giant cells of uniformly distributed osteoclastic type (HE staining, x40)
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F7
Postoperative histopathology established the diagnosis of GCT of the iliac bone, with the morphological picture characteristic of this lesion: tumor proliferation combining two complex cellular contingencies, represented by benign, oval or discreet mononuclear tumor cells and numerous multinuclear giant cells of the large osteoclastic type, evenly distributed among the mononuclear cells and displaying the same nuclear traits with these (Figures 6 and 7).
Area of partial destruction of the cortical bone through the giant cell tumor (HE staining, x40)
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F8
The examination of the multiple processed sections revealed partial destruction or total in other cortical bone areas (Figures 8 and 9), invasion of periosteal soft tissues (periosteum, tenomuscular insertion and layer of muscle tissue) and occasional formation, limited by immature bone, reactive (Figures 10 and 11), to the periphery of the infiltrating tumor.
Cortical bone erosion with the extension of the giant cell tumor in the soft tissues (HE staining, x40)
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F9
The examination of the multiple processed sections revealed partial destruction or total in other cortical bone areas (Figures 8 and 9), invasion of periosteal soft tissues (periosteum, tenomuscular insertion and layer of muscle tissue) and occasional formation, limited by immature bone, reactive (Figures 10 and 11), to the periphery of the infiltrating tumor.
Giant cell tumor of bone. Peripheral focal immature reactive bone formation (HE staining, x100)
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F10
The examination of the multiple processed sections revealed partial destruction or total in other cortical bone areas (Figures 8 and 9), invasion of periosteal soft tissues (periosteum, tenomuscular insertion and layer of muscle tissue) and occasional formation, limited by immature bone, reactive (Figures 10 and 11), to the periphery of the infiltrating tumor.
Bone dispersion of giant cell tumor (HE staining, x100)
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F11
The examination of the multiple processed sections revealed partial destruction or total in other cortical bone areas (Figures 8 and 9), invasion of periosteal soft tissues (periosteum, tenomuscular insertion and layer of muscle tissue) and occasional formation, limited by immature bone, reactive (Figures 10 and 11), to the periphery of the infiltrating tumor.