Fine-needle aspiration of a solitary pulmonary nodule following treatment of metastatic giant-cell tumor of bone.
Giant cell tumor (GCT) of bone is a local, variably aggressive neoplasm with high local recurrence and occasional pulmonary metastases. Radiographically guided fine-needle aspiration (FNA) plays a large role in establishing a tissue diagnosis of lung metastases prior to therapeutic intervention. We present a patient with histologically proven pulmonary metastases from a femoral grade II GCT. These lesions were obliterated with combination HT-CT (hyperthermia and chemotherapy). The patient subsequently developed another pulmonary nodule at a site previously occupied by a GCT metastatic deposit. Radiographically guided FNA revealed that this new lesion was an adenocarcinoma, apparently of pulmonary origin. We suggest that this second neoplasm arose within a scar that developed after HT-CT ablation of one of the metastases. Additional intriguing features of this case are the effective HT-CT therapy of GCT metastatic to lung and the extended temporal course (some 16 yr from initial diagnosis to death).
Powers
C N
CN
Department of Pathology and Laboratory Medicine, University of Texas Health Science Center, San Antonio 78284-7750.
Bull
J M
JM
Raval
P
P
Schmidt
W A
WA
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D001707:Biopsy, Needle; D001859:Bone Neoplasms / Q000473:pathology; D005870:Giant Cell Tumors / Q000473:pathology / Q000556:secondary*; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D003074:Solitary Pulmonary Nodule / Q000473:pathology*