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Case Reports
. 2025 Feb 1:43:544-550.
doi: 10.1016/j.jpra.2025.01.020. eCollection 2025 Mar.

Rare presentation and resection of giant cell tumor invading the middle ear and skull base: A case report

Joshua M Cohen  1 , Geena Jung  1 , Hailey Reisert  1 , Yi-Hsueh Lu  2 , Genesis Liriano  3 , Bradley A Schiff  4 , Evan S Garfein  2 , Andrew J Kobets  3
Affiliations
Case Reports

Rare presentation and resection of giant cell tumor invading the middle ear and skull base: A case report

Joshua M Cohen et al. JPRAS Open. .

Abstract

Giant cell tumors (GCTs) are common benign bone tumors found in young adults, frequently occurring in the long bones but rarely in the skull. Although considered benign, GCTs have the potential to be aggressive, destroying surrounding tissue. Here, we present the unusual case of a patient with a GCT of the middle ear and skull base. A 19-year-old male with an extensive giant cell tumor underwent surgical resection by a multidisciplinary team consisting of otolaryngology, neurosurgery, and plastic and reconstructive surgery. The mass was grossly resected, and a cervicofacial flap allowed for reconstruction with optimal cosmesis, a procedure not described for GCTs. This approach allowed for excellent wound healing without tumor recurrence. Gross total resection remains the most effective treatment for GCTs, minimizing radiation exposure and recurrence risk. However, an optimal surgical approach for skull GCTs has yet to be described. Skull-base GCTs present a challenge due to their complex anatomy and neurovascular elements. Further, the high rates of local recurrence make gross resection the goal of treatment, though this is difficult to achieve. The present case was successfully managed by extensive multidisciplinary surgical resection, highlighting the necessity of collaborative effects to achieve gross total resection and positive aesthetic outcomes.

Keywords: Cervicofacial flap; Giant cell granuloma; Giant cell tumor; Middle ear; Multidisciplinary; Skull base.

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Conflict of interest statement

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Figures

Figure 1
Figure 1
Pre-operative image demonstrating the mass protruding anteriorly and posteriorly to the left outer ear.
Figure 2
Figure 2
Sagittal MRI demonstrating the large invasive Giant Cell Tumor (GCT). The mass is noted to be extending through the middle ear, into the skull base, and displaces the parotid gland.
Figure 3
Figure 3
Intraoperative image demonstrating the depth of tumor invasion and adhesion to the facial nerve, parotid gland, and temporal bone.
Figure 4
Figure 4
Post-operative image demonstrating the cervicofacial flap with aesthetic deformity correction.
Figure 5
Figure 5
Image taken at 38 months post-operatively to demonstrate continued excellent healing.
See this image and copyright information in PMC

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