Giant cell tumour of first metacarpal bone

Abstract

Giant cell tumour (GCT) or osteoclastoma is a benign locally aggressive tumour with a tendency for local recurrence. 85-90% of cases occur in long bones; the sites most commonly affected being lower end of femur, upper end of tibia, lower end of radius and proximal humerus in descending order of frequency. Only 2% of GCT occurs in hand. GCT of bone accounts for 5% of all primary bone tumour. 80% of patients are above the age of 18 years, and it occurs commonly in adults between ages of 20 and 40 years. The authors report a case of GCT of first metacarpal which is very rare site for such tumour and only few cases reported in literature so far.

Figure 1

(A) Frontal radiographs revealed an expansile osteolytic lesion of the first metacarpal involving diaphysis with metaphyseal extension. (B) Lateral radiograph of hand reveals multiloculated expansile osteolytic lesion with evidence of comminuted pathological fracture involving first metacarpal with prominent adjacent soft tissue.

Figure 2

Section shows sheets of round, oval or elongated mononuclear cells evenly intermixed with numerous osteoclast-like giant cells (H&E ×500).