Malignant giant-cell tumor of the parietal bone: case report and review of the literature.
OBJECTIVE
Giant-cell tumors (GCTs) are primary bone tumors that involve long bones in 75 to 90% of patients. They seldom develop in the cranium and are very rare in patients older than 60 years of age. A GCT rarely occurs with Paget's disease; when it does, however, it is most commonly associated with the polyostotic form and tends to involve the craniofacial bones. Pagetic GCTs are less aggressive than GCTs that are not associated with Paget's disease.


METHODS
We report the case of an 81-year-old woman with a painless left parietal mass and asymptomatic monostotic parietal Paget's disease.


METHODS
Surgical resection was performed, and histological examination of the lesion demonstrated Paget's disease with a malignant GCT. An incidental, low-grade, small-cell lymphocytic lymphoma also was noted. The patient experienced local recurrence of the malignant GCT and eventually died after developing pulmonary metastases of the malignant GCT.


CONCLUSIONS
This case is the first reported example of a patient with a malignant GCT of the cranium associated with monostotic Paget's disease. It provides evidence that not all pagetic GCTs in the cranium are benign, as has been reported.
Leonard
J
J
Department of Neurosurgery, Washington University School of Medicine, St Louis, Missouri 63110, USA. Jleonard@pathology.wustl.edu
Gökden
M
M
Kyriakos
M
M
Derdeyn
C P
CP
Rich
K M
KM
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005870:Giant Cell Tumors / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D010001:Osteitis Deformans / Q000150:complications; D010294:Parietal Bone; D012888:Skull Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed