Giant Cell Tumor of the Proximal Fibula in a 15-year-old Female: A Review and Case Report

Abstract

Background/aim: Giant cell tumor of the bone (GCTB) is a locally-aggressive, benign tumor that typically affects young adults between 20 and 40 years old.

Case report: A 15-year-old female presented to a primary care physician with pain in the lateral aspect of the left knee and was referred to our department with a suspected bone tumor owing to radiographic findings of osteolysis of the proximal fibula. Computed tomography indicated osteolysis of the proximal fibula, and the bone cortex was thin and partially irregular. Magnetic resonance imaging indicated a mass in the same area, with hyperintense changes in both T1- and T2-weighted images. No biopsy was performed; however, bone tumor curettage and artificial bone grafting were performed. The final pathological examination indicated osteoclastic, multinucleated giant cells. No malignant findings were observed, and the patient was diagnosed with GCTB. No recurrence was observed one year after surgery.

Conclusion: This case highlights the occurrence of GCTB in a young patient at an uncommon location. Oncologic surgeons should consider GCTB as a differential diagnosis when an image shows translucency of the proximal fibula, even if the patient is younger than the usual age of onset.

Keywords: Fibula; case report; child; giant cell tumor of bone.

Figure 1

Radiographs of the left proximal fibula (A, coronal section; B, sagittal section) Bone translucency can be observed in the proximal fibula (red arrowhead). Computed tomography image of the left proximal fibula (C, coronal section; D, sagittal section). The bone cortex is thin and irregular (red arrowhead).

Figure 2

Magnetic resonance imaging of the left proximal fibula showing a neoplastic lesion in the proximal fibula with iso- or hyperintensity on the T1-weighted image (A) and iso- or hyperintensity on the T2-weighted image (B). In addition, edematous changes can be observed in the soft tissue around the proximal fibula (B, red arrowheads). Postoperative radiographic image of the left proximal fibula (C, red arrowhead). The artificial bone was filled after tumor curettage (D, red arrowhead).

Figure 3

Pathological findings of the excised specimen: Hematoxylin and eosin-stained image. Osteoclastic multinucleated giant-cell proliferation can be observed. No malignancy can be observed. Magnification ×400; scale bar=100 μm.