Osteoclastoma.pptx

Regarding osteoclastoma

1. Giant cell tumor Done by : Aleena Abraham

2. Introduction Multinucleated Osteoclastic type giant cell Neoplastic mononuclear cells Relatively uncommon Locally aggressive Potentially malignant neoplasm

3. Age b/w 20 and 40 years of age as it mainly affects matured skeletal bones Sex - slightly predominant in females COO - primitive stromal cells

4. Pathogenesis Neoplastic cells - primitive osteoblast precursors Neoplastic cells – high level of RANKL Promote the proliferation of osteoclast precursors
their differentiation into mature osteoclasts through
RANK expressed by these cells.

5. Morphology Site Giant-cell tumors involve epiphyses but may extend into the metaphysis of a long bone. Bones Involved Any bone can be involved, majority arise in: Knee area: Distal femur and proximal tibia. Lower end of radius , humerus, fibula

6. Radiological examination Giant-cell tumor: Soap-bubble appearance on X-ray examination
a lytic lesion and grows slowly, expands the bone and destroys the overlying cortex. The tumor produces a bulging soft tissue mass surrounded by a thin, shell of reactive bone due to periosteal reaction.

7. Gross Largentumor , clearly circumscribed frequently undergo cystic change Cut surface – Soft and red-brown without bone or calcification – Numerous hemorrhagic areas give an appearance of a sponge full of blood

8. Microscopy Two types of cells 1. Mononuclear (stromal) cells: Neoplastic cells Mitotic activity - common
Diagnosis- morphology of mononuclear cells the multinucleated giant cells. The nuclei of these cells
the osteoclasts are similar. The tumor cells do not synthesize bone or cartilage.

9. Multinucleated (osteoclastic) giant cells: The background shows numerous large osteoclast-type giant cells throughout the richly vascularized stroma. 100 or more nuclei Area of cystic degeneration, necrosis and mitotic figures may be seen

10. Clinical Manifestations Commonly seen near knee joints. Pain (usually in the joint adjacent to the tumor) and arthritis-like symptoms.
Microfractures and pathologic fractures may develop due to thinning of the cortex

11. Spread Local spread: Tumor is usually restricted within the involved bone surrounded by periosteum. – Aggressive tumors may penetrate the cortex and the periosteum, and may involve the joint capsule and the synovial membrane. Hematogenous spread: Common site is lung

12. Thank you