Abstract

Introduction: Skull Base Giant Cell Tumors (GCT) are rare tumors of bone usually seen in the epiphyseal edges of long bones. They are common in young adults and have a slight female preponderance. Their Axial skeleton incidence is very rare, which makes their identification and management challenging. Although surgery is the main modality of management, the presence of sensitive structures in the vicinity makes for the necessity of multi-modality therapy to allow acceptable disease free and symptom free survival.

Case Report: We present two different patients with skull base GCT. The first is a central skull base GCT with two recurrences due to inadequate therapy. The challenge in this patient was diagnosis and management of the recurrent tumor without worsening the neurological deficits. New age Chemotherapy along with a judicious use of biopsy resulted in an excellent long-term response.
The second patient had a dumbbell shaped middle cranial fossa mass on the cavernous sinus extending from the orbital apex to the posterior cranial fossa. The histopathological diagnosis came as a surprise as all radiological and operative inputs pointed to a trigeminal schwannoma. This report highlights the need to keep an open mind and suspect a GCT even in improbable scenarios.

Conclusion: Skull base GCTs are rare but complex tumors owing to their low incidence and complex anatomical challenges presented by the location and behavior of the lesions. A high index of suspicion along with thorough knowledge of anatomy of the skull base is essential for management of these tumors. Despite surgery being the preferred modality of treatment, complex anatomical predicaments require adjuvant therapies to be employed to effect disease free and symptom free survival. A multidisciplinary approach is recommended for ensuring the best outcomes for patients.

Keywords: Giant Cell Tumor; Skull Base; Chemotherapy

References

1. Fletcher CDM., et al. “Pathology and Genetics of Tumours of Soft Tissue and Bone” (2002).
2. Werner M. “Giant cell tumour of bone: morphological, biological and histogenetical aspects”. International Orthopaedics 30.6 (2006): 484-489. 
3. Karras NA., et al. “Denosumab treatment of metastatic giant-cell tumor of bone in a 10-year-Old girl”. Journal of Clinical Oncology 31.12 (2013): e200-e202. 
4. Thomas D and Skubitz K. “Giant cell tumour of bone”. Current Opinion in Oncology 21.4 (2009): 338-344.
5. Miller IJ., et al. “A case of recurrent giant cell tumor of bone with malignant transformation and benign pulmonary metastases”. Diagnostic Pathology 5.1 (2010): 62. 
6. Purohit S and Pardiwala DN. “Imaging of giant cell tumor of bone”. Indian Journal of Orthopaedics 41.2 (2007): 91-96. 
7. Zhao J., et al. “Giant cell tumor of the clivus: A case report and review of the literature”. Oncology Letters 8.6 (2014): 2782-2786.
8. Chatterjee D., et al. “Sphenoid bone: a rare site for giant cell tumor - case report with literature review”. Clinical Neuropathology 35.6 (2016): 385-388. 

Citation

Citation: Sibhi Ganapathy and Vidya Baliga. “Skull Base Giant Cell Tumors - A Case Series and Review of Literature".Acta Scientific Neurology 3.4 (2020): 27-30.

Copyright

Copyright: © 2020 Sibhi Ganapathy and Vidya Baliga. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.