giant cell tumor of the skull
Introduction
Introduction to giant cell tumor of the skull Giant cell tumor of the skull is most common with sphenoid bone and tibia. The tumor may be benign in histology, but the local may be highly invasive, and a few may even metastasize to the lungs. basic knowledge Sickness ratio: 0.05% Susceptible people: no special people Mode of infection: non-infectious complication:
Cause
Cause of skull giant cell tumor
(1) Causes of the disease
Tumors are thought to originate from mesoderm cells of non-osteogenic connective tissue in the bone marrow.
(two) pathogenesis
The tumor consists of mononuclear interstitial cells and scattered multinucleated giant cells. The interstitial cells are the main components of the tumor. It determines the nature of the tumor. In 53% of patients, large spindle cell proliferation is seen around the giant cell tumor of the bone, and the spindle cells do not. The characteristics of malignant tumors have nothing to do with the prognosis. Jaffe classifies tumors into three grades according to histological features, which are benign, potentially malignant and malignant. Benign morbidity accounts for the absolute advantage of such diseases. Tumors generally grow slowly. Rarely occurs, but in local infiltration and growth, the tumor is very osteolytic, but there is no damage to the soft tissue, and there are many bleeding areas in the tumor.
The tumor can be either solid or cystic. The tumor surface is grayish-white or yellow-brown. The bleeding and necrotic areas are often seen. If there is a large piece of bleeding, it is reddish brown or dark brown. The tumor interstitial blood vessels are rich, and the tumor grows. Active, cystic tumors form a multi-atrial or single-shot larger cyst, and some have a thin film on the inner wall of the capsule. The capsule is filled with a brown or yellow-brown plasma or bloody liquid.
Prevention
Cranial giant cell tumor prevention
No preventive measures, early detection, early treatment.
Complication
Cranial giant cell tumor complications Complication
Tumors near the sphenoid bone and saddle area can cause visual impairment, visual field defects, and oculomotor nerves, impaired nerves and trigeminal nerve damage. Giant cell tumors that occur at the base of the cranial fossa can cause repeated infections and hearing loss.
Symptom
Cranial giant cell tumor symptoms Common symptoms Intracranial calcification paralysis
The course of the disease is slow, and the sacs of different sizes protrude into the cranium to cause corresponding symptoms. In the early stage of tumor volume, the patient can be asymptomatic. When the tumor reaches a certain volume, it causes cranial nerve palsy and headache, such as occurs in the vicinity of the sphenoid bone and the saddle area. The giant cell tumor at the base of the cranial fossa may have clinical manifestations of the corresponding parts, and the tumor may show strong invasion and even death.
Examine
Examination of giant cell tumor of the skull
It is the same as the giant cell tumor of the other parts of the body. It is a simple osteolytic change. The most common site is the midline of the sphenoid bone. The soft tissue-like tumor is common. The soft tissue is related to bone destruction, but there is no specificity in imaging. Sexual characteristics to confirm the diagnosis.
Skull X-ray films can be divided into three types:
1. Multi-capsule irregular multi-atrial bone destruction area, there are residual large bone beams, sharp edges and high-density lines.
2. The single-capsule type is an expansive bone destruction zone. There is no trabecular space in the tumor. X-ray examination such as bone cyst, internal and external plates are separated, and there is a high-density osteosclerosis around.
3. Simple bone destruction type non-swelling bone destruction, no cystic appearance.
CT showed uniform high-density lesions, no enhancement or slight enhancement. MRI can identify the location of the tumor and the anatomical relationship with the surrounding tissue.
Diagnosis
Diagnosis and identification of giant cell tumor of skull
diagnosis
Based on clinical manifestations and imaging characteristics, a preliminary diagnosis can be made.
Differential diagnosis
Intracranial giant cell tumors should be differentiated from other common tumors, such as chordoma, large pituitary tumors, nasopharyngeal carcinoma, and metastatic cancer. Because of the relatively high degree of malignancy of giant cell tumor of the skull, it is on histopathology. It should be differentiated from the same giant cell-containing tumors, including giant cell repair granuloma, hyperparathyroidism, chondroblastoma, bone fibrous dysplasia and aneurysmal bone cyst, giant cell repair granulation The swelling can invade the cheeks, the ankles and the bones outside the iliac crest, the giant cell repair granuloma has irregularly distributed giant cells, the osteogenic metaplasia on the fibroblastic collagen matrix, and the giant cell repair granuloma The characteristics are that the cells surrounding the giant cells are slender, and the hyperparathyroidism is the same as that of the giant cell repair granuloma. It must be identified by laboratory tests. The chondroblastoma is more than the giant cell repair granulation. Less swollen, it is characterized by local cartilage differentiation and proliferation, the formation of nodular or banded deep-stained epithelioid cells, scattered distribution of giant cells and blood iron pigment particles, Pulse tumor-like bone cysts and poor bone fiber structure can be differentiated from giant cell tumors by the fibroblastic properties of spindle cell proliferation and the structure of bone formation. Occasionally, the differentiation of giant cell tumors and metastatic carcinomas is difficult. Hair foci, clear diagnosis, giant cell repair granuloma can usually be controlled by simple surgery, no radiation therapy, and radiotherapy is part of the complete treatment of giant cell tumor of the skull. Surgical treatment alone can not control the development of the disease, so identify the giant bone Cell tumors and giant cell repair granuloma are important.
