MALIGNANT GIANT CELL TUMOR OF SOFT PARTS IN LUMBOSACRAL REGION

Abstract: Objective: Giant cell tumor of soft parts is a rare neoplasm that mainly affects adulst and the elderly and is usually located in the extremities. Here we report a child with giant cell tumor of soft tissue, which is a very rare condition in childhood. Clinical presentation: A 5 year old girl presented with a 5 month history of left lower extremity pain. She had developed paraplegia before admission. On examination, mild left lumbosacral swelling and tenderness was found. Abdominal and pelvic CT-Scan revealed an expansile lytic lesion of the left side of sacrum with significant soft tissue component extending toward the left iliac bone. Lumbar MRI revealed a space occupying lesion originating from posterior L5 elements, projecting toward the L1. Intervention: The patient underwent surgery. A firm epidural hemorrhagic tumor of L5, S1, S2 with no spinal cord involvement was found. Partial tumor resection (measuring 3*1*0.5 cm in maximal diameter) and laminectomy was done. Conclusion: Primary giant cell tumors of soft tissue are distinctive, rare neoplasms that exhibit a wide clinicopathologic spectrum similar to osseous GCTs and need to be differentiated from other giant cell rich soft tissue tumors. Recognition of this tumor is important due to its behavior as a low grade malignancy, but this cannot be predicted and metastasis does occur rarely. Keywords: Giant cell tumor of soft tissue (GCT-ST), Large cell sarcoma of tendon sheath. Please cite this article as: Jadali F, Almasi A, Gharib A. Malignant giant cell tumor of soft parts in lumbosacral region.Iran J Cancer Prev. 2008 ; 1(2):87-89. References: 1. Soft tissue. Thomas Stocker J, Dehner Lovis P. Pediatrtic pathology, 2th Ed. Lipponcott Williams and Wilkins; 2001, P 1201. 2. Soft tissue. Rosai J. Rosai and Ackerman's surgical pathology, 9th Ed. Edinburg, MOSBY; 2004, P 2323-4. 3. Col Kaiash Chand, Lt Col RK Bhardway, Maj TJ Rappai. Study of 7 cases of giant cell tumor of soft tissue. MJFI 2006; 62: 138-140. 4. Icihikawa K, Tanino R. Soft tissue giant cell tumor of Low malignant potential. Tokai J Exp Clin Med. 2004 Sep; 29 (3): 91-5. 5. Oliveria, Andre M, Dei Tos, Angelo P, Fletcher, Christopher D M. Primary giant cell tumor of soft tissues: A study of 22 cases. Am J Surg Pathol 2000; 24 (2): 248­ 256. 6. Connell JXO, Wehril BM, Nielsen GP, Rosenberg AE. Giant cell tumors of soft tissue: A clinicopathologic study of 13 benign and malignant tumors. Am J Surg Pathol 2000; 24 (3): 386-95. 7. Fletcher CDM, Unni KK, Mertens F. Pathology and genetics of tumors of soft tissue and bone. IN: Kleihues P, Sobin LH, editors. WHO classification of tumors. Lyon: IARC press; 20025, 118-119. 8. Flope AL, Morris RJ, Weiss SW. Soft tissue giant cell tumor of low malignant potential: A proposal for the reclassification of malignant giant cell tumor of soft parts. Mod Pathol. 1999; 12 (9): 894-902. 9. Valerie AH and Rosalie E. Primary giant cell tumor of soft tissue. Journal of Cutaneou Pathology 2001; 28 (9): 492-5. 10. Enzinger FM. Giant cell malignant fibrohistiocytoma. In: Weiss SW, Goldblum JR, editor. Enzinger and Weiss's soft tissue tumors. 4th Ed. St Louis: MOSBY; 2001: 535-61. 11. Verhangen, Wim IM, Bartels, Ronald HMH, Schaafsma Ewout. A giant cell tumor of the sacrum or a soft tissue giant cell tumor? : A case report. Spine; 1998 Jul, 23 (14): 1609-1611.