Download PDF
J Neurol Surg A Cent Eur Neurosurg 2016; 77(03): 239-246
DOI: 10.1055/s-0035-1554808
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Giant Cell Tumor of the Skull: Review of the Literature

Ryota Tamura
1   Department of Neurosurgery, Ashikaga Red Cross Hospital, Ashikaga City, Japan
,
Tomoru Miwa
1   Department of Neurosurgery, Ashikaga Red Cross Hospital, Ashikaga City, Japan
,
Kazuhiko Shimizu
2   Department of Pathology, Ashikaga Red Cross Hospital, Ashikaga City, Japan
,
Katsuhiro Mizutani
1   Department of Neurosurgery, Ashikaga Red Cross Hospital, Ashikaga City, Japan
,
Hideyuki Tomita
1   Department of Neurosurgery, Ashikaga Red Cross Hospital, Ashikaga City, Japan
,
Nobuo Yamane
3   Department of Oral Surgery, Ashikaga Red Cross Hospital, Ashikaga City, Japan
,
Takehiro Tominaga
4   Department of Otorhinolaryngology, Ashikaga Red Cross Hospital, Ashikaga City, Japan
,
Shunichi Sasaki
4   Department of Otorhinolaryngology, Ashikaga Red Cross Hospital, Ashikaga City, Japan
› Author Affiliations
Further Information

Publication History

28 April 2014

10 March 2015

Publication Date:
19 June 2015 (online)

Also available at
   Permissions and Reprints

Abstract

Background Giant cell tumors (GCTs) are rare in the skull. The present report describes a case with a primary GCT located in the temporal bone and reviews the relevant literature. We also propose a treatment strategy for GCT of the skull.

Clinical Presentation A 41-year-old man presented with headache and auditory disturbance. Radiologic images showed a lytic expansive extradural lesion originating primarily from the right temporal bone and expanding into the middle cranial fossa and the infratemporal fossa. A biopsy specimen of the lesion was obtained from the external auditory meatus. Total removal was performed with temporal craniectomy, mandibular condylar process removal, tympanoplasty, and mastoidectomy.

Discussion The rate of recurrence of GCTs is related to complete resection and location of the GCT rather than to the degree of invasiveness. Some of the mononuclear cells and stromal cells in GCT express receptor activator of nuclear factor κ-β ligand (RANKL). Because inhibition of RANKL and bisphosphonate therapy might eliminate giant cells, this approach might be useful for recurrent or unresectable GCTs of the skull.

Conclusions Preoperative diagnosis by biopsy is important in determining the therapeutic strategy of GCTs. Complete resection is important to reduce the recurrence rate of GCTs in the skull.

Keywords

giant cell tumor - bisphosphonate - RANKL - denosumab - temporal bone
 

  • References

  • 1 Chiarini L, Figurelli S, Ghidini A , et al. An unusual case of giant cell tumour involving the middle cranial fossa, originating from soft tissues of the temporomandibular joint. Acta Neurochir (Wien) 2009; 151 (12) 1685-1687
    CrossrefPubMedGoogle Scholar
  • 2 Elder JB, Berry C, Gonzalez-Gomez I, Kreger MD, McComb JG. Giant cell tumor of the skull in pediatric patients. Report of two cases. J Neurosurg 2007; 107 (1, Suppl): 69-74
    PubMedGoogle Scholar
  • 3 Findlay JM, Chiasson D, Hudson AR, Chui M. Giant-cell tumor of the middle cranial fossa. Case report. J Neurosurg 1987; 66 (6) 924-928
    CrossrefPubMedGoogle Scholar
  • 4 Harris AE, Beckner ME, Barnes L, Kassam A, Horowitz M. Giant cell tumor of the skull: a case report and review of the literature. Surg Neurol 2004; 61 (3) 274-277
    CrossrefPubMedGoogle Scholar
  • 5 Iizuka T, Furukawa M, Ishii H , et al. Giant cell tumor of the temporal bone with direct invasion into the middle ear and skull base: a case report. Case Rep Otolaryngol 2012; 2012: 690148
    PubMedGoogle Scholar
  • 6 Kamoshima Y, Sawamura Y, Imai T, Furukawa H, Kubota K, Houkin K. Giant cell tumor of the frontal bone in a girl: case report. Neurol Med Chir (Tokyo) 2011; 51 (11) 798-800
    CrossrefPubMedGoogle Scholar
  • 7 Kashiwagi N, Hirabuki N, Andou K , et al. MRI and CT findings of the giant cell tumors of the skull; five cases and a review of the literature. Eur J Radiol 2006; 58 (3) 435-443
    CrossrefPubMedGoogle Scholar
  • 8 Park Y-S, Lee JK, Baek S-W, Park CK. The rare case of giant cell tumor occuring in the axial skeleton after 15 years of follow-up: case report. Oncol Lett 2011; 2 (6) 1323-1326
    PubMedGoogle Scholar
  • 9 Tang J-Y, Wang C-K, Su Y-C, Yang SF, Huang MY, Huang CJ. MRI appearance of giant cell tumor of the lateral skull base: a case report. Clin Imaging 2003; 27 (1) 27-30
    CrossrefPubMedGoogle Scholar
  • 10 Wolfe III JT, Scheithauer BW, Dahlin DC. Giant-cell tumor of the sphenoid bone. Review of 10 cases. J Neurosurg 1983; 59 (2) 322-327
    CrossrefPubMedGoogle Scholar
  • 11 Yamamoto M, Fukushima T, Sakamoto S, Tomonaga M. Giant cell tumor of the sphenoid bone: long-term follow-up of two cases after chemotherapy. Surg Neurol 1998; 49 (5) 547-552
    CrossrefPubMedGoogle Scholar
  • 12 Echols DH. Giant cell tumor of the sphenoid bone- report of a case. J Neurosurg 1945; 2: 16-20
    CrossrefPubMedGoogle Scholar
  • 13 Balke M, Campanacci L, Gebert C , et al. Bisphosphonate treatment of aggressive primary, recurrent and metastatic giant cell tumour of bone. BMC Cancer 2010; 10: 462
    CrossrefPubMedGoogle Scholar
  • 14 Chaudhary P, Khadim H, Gajra A, Damron T, Shah C. Bisphosphonate therapy is effective in the treatment of sacral giant cell tumor. Onkologie 2011; 34 (12) 702-704
    CrossrefPubMedGoogle Scholar
  • 15 Thomas D, Henshaw R, Skubitz K , et al. Denosumab in patients with giant-cell tumour of bone: an open-label, phase 2 study. Lancet Oncol 2010; 11 (3) 275-280
    CrossrefPubMedGoogle Scholar
  • 16 Thomas DM. RANKL, denosumab, and giant cell tumor of bone. Curr Opin Oncol 2012; 24 (4) 397-403
    CrossrefPubMedGoogle Scholar
  • 17 Tse LF, Wong KC, Kumta SM, Huang L, Chow TC, Griffith JF. Bisphosphonates reduce local recurrence in extremity giant cell tumor of bone: a case-control study. Bone 2008; 42 (1) 68-73
    CrossrefPubMedGoogle Scholar
  • 18 Roberts DS, Faquin WC, Deschler DG. Giant cell tumors of the temporal bone and infratemporal fossa: a case report and review of the literature. Laryngoscope 2010; 120 (Suppl. 04) S180
    CrossrefPubMedGoogle Scholar
  • 19 Buckle CH, De Leenheer E, Lawson MA , et al. Soluble rank ligand produced by myeloma cells causes generalised bone loss in multiple myeloma. PLoS ONE 2012; 7 (8) e41127
    CrossrefPubMedGoogle Scholar
  • 20 Ikeda T, Kasai M, Utsuyama M, Hirokawa K. Determination of three isoforms of the receptor activator of nuclear factor-kappaB ligand and their differential expression in bone and thymus. Endocrinology 2001; 142 (4) 1419-1426
    PubMedGoogle Scholar
  • 21 Isaacson B, Berryhill W, Arts HA. Giant-cell tumors of the temporal bone: management strategies. Skull Base 2009; 19 (4) 291-301
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Gupta R, Mohindra S, Mahore A, Mathuriya SN, Radotra BD. Giant cell tumour of the clivus. Br J Neurosurg 2008; 22 (3) 447-449
    CrossrefPubMedGoogle Scholar
  • 23 Doumouchtsis K, Perrea D, Doumouchtsis S , et al. Regulatory effect of parathyroid hormone on sRANKL-osteoprotegerin in hemodialysis patients with renal bone disease. Ther Apher Dial 2009; 13 (1) 49-55
    CrossrefPubMedGoogle Scholar
  • 24 Dovio A, Generali D, Tampellini M , et al. Variations along the 24-hour cycle of circulating osteoprotegerin and soluble RANKL: a rhythmometric analysis. Osteoporos Int 2008; 19 (1) 113-117
    CrossrefPubMedGoogle Scholar
  • 25 Jung K, Lein M, Hösslin Kv , et al. Osteoprotegerin and receptor activator of nuclear factor-kappaB ligand (RANKL) in the serum of healthy adults. Int J Biol Markers 2002; 17 (3) 177-181
    PubMedGoogle Scholar
  • 26 Ohwada R, Hotta M, Sato K, Shibasaki T, Takano K. The relationship between serum levels of estradiol and osteoprotegerin in patients with anorexia nervosa. Endocr J 2007; 54 (6) 953-959
    CrossrefPubMedGoogle Scholar
  • 27 Zhu LL, Bao NR, Zhou LW, Guo T, Zeng XF, Zhao JN. Concentration measurement of the OPG and sRANKL of peripheral blood among normal healthy people [in Chinese]. Zhongguo Gu Shang 2010; 23 (2) 87-89
    PubMedGoogle Scholar
  • 28 Henry DH, Costa L, Goldwasser F , et al. Randomized, double-blind study of denosumab versus zoledronic acid in the treatment of bone metastases in patients with advanced cancer (excluding breast and prostate cancer) or multiple myeloma. J Clin Oncol 2011; 29 (9) 1125-1132
    CrossrefPubMedGoogle Scholar
  • 29 Lipton A, Fizazi K, Stopeck AT , et al. Superiority of denosumab to zoledronic acid for prevention of skeletal-related events: a combined analysis of 3 pivotal, randomised, phase 3 trials. Eur J Cancer 2012; 48 (16) 3082-3092
    CrossrefPubMedGoogle Scholar
  • 30 Rock JP, Mahmood A, Cramer HB. Giant cell tumor of the skull base. Am J Otol 1994; 15 (2) 149-152
    CrossrefPubMedGoogle Scholar
  • 31 Watkins LD, Uttley D, Archer DJ, Wilkins P, Plowman N. Giant cell tumors of the sphenoid bone. Neurosurgery 1992; 30 (4) 576-581
    CrossrefPubMedGoogle Scholar
  • 32 Chan J, Gannon FH, Thompson LDR. Malignant giant cell tumor of the sphenoid. Ann Diagn Pathol 2003; 7 (2) 100-105
    CrossrefPubMedGoogle Scholar
  • 33 Company MM, Ramos R. Giant cell tumor of the sphenoid. Arch Neurol 2009; 66 (1) 134-135
    CrossrefPubMedGoogle Scholar
  • 34 Epstein N, Whelan M, Reed D, Aleksic S. Giant cell tumor of the skull: a report of two cases. Neurosurgery 1982; 11 (2) 263-267
    CrossrefPubMedGoogle Scholar
  • 35 Ohaegbulam SC , Indu M. Gupta. Giant cell tumour of the sphenoid bone with dural extension. J Neurol Neurosurg Psychiatry 1977; 40 (8) 790-794
    CrossrefPubMedGoogle Scholar
  • 36 He D, Yang C, Shen G , et al. Navigation-guided resection for a tenosynovial giant cell tumor involving the temporomandibular joint and skull base. J Craniofac Surg 2012; 23 (2) 521-523
    CrossrefPubMedGoogle Scholar
  • 37 Lee JA, Bank WO, Gonzalez-Melendez M, Olan WJ, Tabbara SO. Giant cell tumor of the skull. Radiographics 1998; 18 (5) 1295-1302
    CrossrefPubMedGoogle Scholar
  • 38 Matsushige T, Nakaoka M, Yahara K , et al. Giant cell tumor of the temporal bone with intratumoral hemorrhage. J Clin Neurosci 2008; 15 (8) 923-927
    CrossrefPubMedGoogle Scholar
  • 39 Motomochi M, Handa Y, Makita Y, Hashi K. Giant cell tumor of the skull. Surg Neurol 1985; 23 (1) 25-30
    CrossrefPubMedGoogle Scholar
  • 40 Pai SB, Lalitha RM, Prasad K, Rao SG, Harish K. Giant cell tumor of the temporal bone—a case report. BMC Ear Nose Throat Disord 2005; 5: 8
    CrossrefPubMedGoogle Scholar
  • 41 Pitkethly DT, Kempe LG. Giant cell tumors of the sphenoid. Report of two cases. J Neurosurg 1969; 30 (3) 301-304
    CrossrefPubMedGoogle Scholar
  • 42 Reed L, Willison CD, Schochet Jr SS, Voelker JL. Giant cell tumor of the calvaria in a child. Case report. J Neurosurg 1994; 80 (1) 148-151
    CrossrefPubMedGoogle Scholar
  • 43 Sheikh M, Chisti FA, Sinan T. Giant cell tumour of the temporal bone: case report and review of the literature. Australas Radiol 1999; 43 (1) 113-115
    CrossrefPubMedGoogle Scholar
  • 44 Spallone A, Flores GL, Zaldivar LO, Estupinan B. Giant cell tumor (osteoclastoma) of the petrous bone: case report. Skull Base Surg 1999; 9 (2) 155-159
    Article in Thieme ConnectPubMedGoogle Scholar
  • 45 Zorlu F, Selek U, Soylemezoglu F, Oge K. Malignant giant cell tumor of the skull base originating from clivus and sphenoid bone. J Neurooncol 2006; 76 (2) 149-152
    CrossrefPubMedGoogle Scholar
  • 46 Carmody RF, Rickles DJ, Johnson SF. Giant cell tumor of the sphenoid bone. J Comput Assist Tomogr 1983; 7 (2) 370-373
    CrossrefPubMedGoogle Scholar
  • 47 Silvers AR, Som PM, Brandwein M, Chong JL, Shah D. The role of imaging in the diagnosis of giant cell tumor of the skull base. AJNR Am J Neuroradiol 1996; 17 (7) 1392-1395
    PubMedGoogle Scholar