title: Giant Cell Tumor of the Skull: Review of the Literature.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurosurgery, Ashikaga Red Cross Hospital, Ashikaga City, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Tamura
authors.affiliation: Department of Neurosurgery, Ashikaga Red Cross Hospital, Ashikaga City, Japan.
authors.forename: Tomoru
authors.initials: T
authors.lastname: Miwa
authors.affiliation: Department of Pathology, Ashikaga Red Cross Hospital, Ashikaga City, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Department of Neurosurgery, Ashikaga Red Cross Hospital, Ashikaga City, Japan.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Mizutani
authors.affiliation: Department of Neurosurgery, Ashikaga Red Cross Hospital, Ashikaga City, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Tomita
authors.affiliation: Department of Oral Surgery, Ashikaga Red Cross Hospital, Ashikaga City, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Yamane
authors.affiliation: Department of Otorhinolaryngology, Ashikaga Red Cross Hospital, Ashikaga City, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Tominaga
authors.affiliation: Department of Otorhinolaryngology, Ashikaga Red Cross Hospital, Ashikaga City, Japan.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Sasaki
mesh_terms: D000328:Adult; D056424:Decompressive Craniectomy / Q000379:methods*; D018212:Giant Cell Tumor of Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D012888:Skull Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D013701:Temporal Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome