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Diffuse tenosynovial giant cell tumor of the cervical spine destroying vertebra C6 - a case report


Authors: Zdeněk Kinkor 1;  Tomáš Svoboda 2;  Petr Grossman 1;  David Bludovský 3;  Filip Heidenreich 4;  Andrej Švec 5;  Iveta Mečiarová 6
Authors‘ workplace: Bioptická laboratoř s. r. o., Šiklův ústav patologie, LF UK, Plzeň 1;  Onkologická klinika, FN a LF UK, Plzeň 2;  Neurochirurgická klinika, FN a LF UK, Plzeň 3;  Klinika zobrazovacích metod, FN a LF UK, Plzeň 4;  Ortopedická klinika, Univerzitná nemocnica Akademika Dérera, Bratislava 5;  Alfa Medical Patológia, FN Ružinov, Bratislava 6
Published in: Čes.-slov. Patol., 52, 2016, No. 4, p. 218-221
Category: Original Article

Overview

Presented is a case of 59-year-old woman with longstanding neck pain who has been promptly operated for spinal cord compression. Imaging studies disclosed ill-defined cervical paravertebral soft tissue mass at the level of vertebra C5/6 abutting left-sided intervertebral joint and destroying neighboring both vertebral arch and processus spinosus. Submitted specimen was interpreted as a possible metastatic skeletal process by clinicians and referring pathologist favored diagnosis of giant cell tumor/osteoclastoma of the bone. Microscopic features were consistent with giant cell lesion where uniform mononuclear mosaic stromal component dominated the unevenly distributed loose clusters of osteoclast-like giant cells frequently imparting appearance of peculiar pseudoalveolar spaces. Additionally, alternating geographic xanthomatous and densely hyalinized/ osteoid-like zones with speckled, coarsely granular haemosiderin pigment completed the variegated structural composition. The tumor infiltrated adjacent striated muscles; either original bone structures and/or extracellular matrix deposits were not identified. Immunohistochemical stains with p63, SATB2, desmin, EMA, clusterin and S100protein turned out to be completely negative. FISH analysis revealed no rearrangement of CSF1 gene. The diagnosis of the diffuse tenosynovial giant cell tumor was rendered.

Keywords:
bone – diffuse tenosynovial giant cell tumor – cervical spine – tendon sheath – intervertebral joint


Sources

1. Bertoni F, Unni, Beabout JW, Sim FH. Malignant giant cell tumor of the tendon sheath and joint (malignant pigmented villonodular synovitis). Am J Surg Pathol 1997; 21: 153-163.

2. Bhadra AK, Pollock R, Tirabosco RP, Skinner JA et al. Primary tumors of the synovium. A report of four cases of malignant tumor. J Bone Joint Surg Br 2007; 89: 1504-1508.

3. Li CF, Wang JW, Huang WW, Hou CC et al. Malignant diffuse-type tenosynovial giant cell tumors: a series of 7 cases comparing with 24 benign lesions with review of the literature. Am J Surg Pathol 2008; 32: 587-599.

4. Imakiire N, Fujimo T, Morii T, Honya K et al. Malignant pigmented villonodular synovitis in the knee - report of a case with rapid clinical progression. Open Orthop J 2011; 7: 13-16.

5. Asano N, Yoshida A, Kobayashi E, Yamaguchi T et al. Multiple metastases from histologically benign intraarticular diffuse-type tenosynovial giant cell tumor: a case report. Hum Pathol 2014; 45: 2355-2358.

6. Righi A, Gambarotti M, Sbaraglia M, Frisoni T et al. Metastasizing tenosynovial giant cell tumor, diffuse-type/pigmented villonodular synovitis. Clin Sarcoma Res 2015; 5: 15.

7. West RB, Rubin BP, Miller MA, Subramanian S et al. A landscape effect in tenosynovial giant cell tumor from activation of CSF1 expression by translocation in a minority of tumor cells. PNAS 2006; 103: 600-605.

8. Cupp JS, Miller MA, Montgomery KD, Nielsen TO et al. Translocation and expression of CSF1 in pigmented villonodular synovitis, tenosynovial giant cell tumor, rheumatoid arthritis and other reactive synovitides. Am J Surg Pathol 2007; 31: 970-976.

9. Moller E, Mandahl N. Mertens F, Panagopoulos I. Molecular identification of COL6A3-CSF1 fusion transcripts in tenosynovial giant cell tumors. Genes Chromosomes Cancer 2008; 47: 21-25.

10. Boland JM, Folpe AL, Hornick JL, Grogg KL. Clusterin is expressed in normal synoviocytes and in tenosynovial giant cell tumors of localized and diffuse types: diagnostic and histogenetic implications. Am J Surg Pathol 2009; 33: 1225-1229.

11. Dingle SR, Flynn JC, Stewart G. Giant cell tumor of the tendon sheath involving the cervical spine. A case report. J Bone Joint Surg Am 2002; 84A: 1664-1667.

12. Furlong MA, Motamedi K, Laskin WB, Vinh TN et al. Synovial-type giant cell tumors of the vertebral column: a clinicopathologic study of 15 cases with a review of the literature and discussion of the differential diagnosis. Hum Pathol 2003; 34: 670-679.

13. Teixeira WG, Lara NA Jr., Narazaki DK, de Oliveira et al. Giant-cell tumor of the tendon sheath in the upper cervical spine. J Clin Oncol 2012; 30: e250-253.

14. Wang K, Zhu B, Yang S, Liu Z et al. Primary diffuse-type tenosynovial giant cell tumor of the spine: a report of 3 cases ad systemic review of the literature. Turk Neurosurg 2014; 24: 804-814.

15. Wong JJ, Phal PM, Wiesenfeld D. Pigmented villonodular synovitis of the temporomandibular joint: a radiologic diagnosis and case report. J Oral Maxillofac Surg 2012; 70: 126-134.

16. Bredell M, Schucknecht B, Bode-Lesniewska B. Tenosynovial, diffuse type giant cell tumor of the temporomandibular joint, diagnosis and management of a rare tumor. J Clin Med Res 2015; 7: 262-266.

17. Qin JR, Jin L, Li KL, Zhang SS et al. Diffuse-type giant cell tumor of the tendon sheath in the temporal region incidentally diagnosed due to a temporal tumor: A report of two cases and review of the literature. Oncol Lett 2015; 10: 1179-1183.

18. Cleven AH, Hocker S, Briaire-de Bruijn I, Szuhai K et al. Mutation analysis of H3F3A and H3F3B as a diagnostic tool for giant cell tumor of bone and chondroblastoma. Am J Surg Pathol 2015; 39: 1576-1583.

19. Oliveira AM, Chou MM. USP6-induced neoplasms: the biologic spectrum of aneurysmal bone cyst and nodular fasciitis. Hum Pathol 2014; 45: 1-11.

20. Blay JY, EL Sayadi H, Thiesse P, Garret J et al. Complete response to imatinib in relapsing pigmented villonodular synovitis/tenosynovial giant cell tumor. Ann Oncol 2008; 19: 821-822.

21. Ravi V, Wang WL, Lewis VO. Treatment of tenosynovial giant cell tumor and pigmented villonodular synovitis. Curr Opin Oncol 2011; 23: 361-366.

22. Cassier PA, Gelderblom H, Stacchiotti S, Thomas D et al. Efficacy of imatinib mesylate for the treatment of locally advanced and/or metastatic tenosynovial giant cell tumor/pigmented villonodular synovitis. Cancer 2015; 118: 1649-1655.

23. Cassier PA, Italiano A, Gomez-Roca CA, Le Tourneau C et al. CSF1R inhibition with emactuzumab in locally advanced diffuse-type tenosynovial giant cell tumor of the soft tissue: a dose-escalation and dose-expansion phase 1 study. Lancet Oncol 2015; 16: 949-956.

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