Large cell

Large Cell Tumor of Bone

File:Large cell Tumor giant cell.jpg

Histological image of a large cell tumor of bone showing characteristic giant cells.

A large cell tumor of bone is a type of bone tumor that is generally benign but can be aggressive and locally destructive. It is characterized by the presence of numerous large, multinucleated giant cells that resemble osteoclasts. These tumors typically occur in the epiphysis of long bones, such as the distal femur, proximal tibia, and distal radius.

Epidemiology

Large cell tumors of bone account for approximately 5% of all primary bone tumors. They are most commonly diagnosed in young adults between the ages of 20 and 40 years. There is a slight female predominance in the occurrence of these tumors.

Pathophysiology

The pathogenesis of large cell tumors of bone is not completely understood. The tumor is composed of a mixture of mononuclear stromal cells and multinucleated giant cells. The stromal cells are considered the neoplastic component, while the giant cells are reactive and resemble osteoclasts.

Clinical Presentation

Patients with large cell tumors of bone typically present with localized pain and swelling. The pain is often insidious in onset and may be associated with decreased range of motion in the affected joint. Pathological fractures can occur due to the weakening of the bone structure.

Diagnosis

File:Large cell Tumor giant cell.jpg

Close-up of giant cells in a large cell tumor of bone.

Diagnosis is based on clinical presentation, imaging studies, and histological examination. X-ray imaging typically shows a lytic lesion in the epiphysis of a long bone. Magnetic resonance imaging (MRI) and computed tomography (CT) scans can provide further detail about the extent of the tumor. A biopsy is necessary to confirm the diagnosis and to differentiate it from other bone lesions.

Treatment

The primary treatment for large cell tumors of bone is surgical resection. The goal is to remove the tumor completely while preserving as much of the surrounding bone and joint function as possible. In some cases, curettage with adjuvant therapy, such as cryotherapy or phenol, is used to reduce the risk of recurrence. In more aggressive cases, wide resection and reconstruction may be necessary.

Prognosis

The prognosis for patients with large cell tumors of bone is generally good, especially if the tumor is completely resected. However, there is a risk of local recurrence, and in rare cases, the tumor can metastasize, most commonly to the lungs.

Related Pages

• Bone tumor
• Osteoclast
• Epiphysis
• Curettage