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🍪🍪Giant Cell🍪🍪
🍪🍪🍪Rich Tumors🍪🍪🍪
🍪🍪 of Bone 🍪🍪

#BSTPath @ariella8 @VijayPatho @Path_Matt @AbhijitSurgPath
Remember this case❓

🔬 Yes! GCT of 🦴
(micro features in view of location + age + radiological/gross features)

Answer to Qs:
DDx based on epiphyseal location alone:
🦴GCT of bone
🦴Clear cell chondrosarcoma

#BSTPath @kriyer68

GCT of 🦴 continues....

☠️Secondary changes:
ABC, storiform fibrous histiocytoma-like, foam cells, focal osteoid

☠️H3F3A gene mutation (encoding histone 3.3): p.G34W

☠️IHC: G34W antibody staining the mononuclear cells

☠️Features that do NOT warrant a diagnosis of malignancy in GCT:

✖️Numerous (but typical) mitoses
✖️Necrosis (usually infarct-type)
✖️Intravascular tumor!
✖️“Benign” lung mets (that’s right!)

@AlanPath @kriyer68 @angelpanizo1

But tumors do not always read 📚🤦🏻‍♀️
Here is a GCT in the hand🖐🏼.
Patient lost follow up & came back with enlarged tumor.

Bones of ✋🏼and 🦶🏼are uncommon locations for GCT of bone
(not to be confused with tenosynovial GCT which preferentially affects these sites!) #bstpath

Targeted therapy with Denosumab💉 is now used.

Post-treatment changes may be confusing to the pathologist if history is lacking.

Here is an excellent example of post-Denosumab GCT by @kells108 :

Back to this from Part1️⃣

Bx 1
41 y/o F, tibia, mid diaphysis, multicystic, 7.3cm, cortical breakthrough, fluid levels, parathyroid mass seen on U/S

Bx 2
22 y/o F, osteolytic lesion, femoral condyle, subarticular, 5 cm, cortical destruction

Much better! and the answer is👇🏻

Case 🎢:
Gross specimen of an osteolytic lesion in distal tibia in a 10-year-old girl👇🏻

Stay tuned for Part3️⃣❗️

#BSTPath #RolaCoaster
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