Giant cell tumor of the sacrum: radiological and morphological characteristics

Introduction. Giant cell tumors (GCT) of bones are benign tumors with the potential for the aggressive course and ability to metastasize. GCT accounts for approximately 5% of all primary bone tumors. Materials and methods. The clinical case of the patient L., 35 years old, with a giant cell tumor of the sacrum is presented. During the preoperative examination according to ultrasound, MSCT and MRI, the patient showed the destruction of the cortical sacrum along the internal contour; a large, extra organized in the form of a rounded shape with clear, uneven contours, cystic-solid structure proceeded from this zone. The lesion was hypervascular, with large lacunae filled with blood. The difficulties in the diagnosis of this lesion and the possibilities of surgical treatment are shown. Establishing diagnosis was possible only according to histological and immunohistochemical studies. Results and discussion. The histogenesis of GCT is still unknown and in the International Histological Classification of Bone Tumors is referred to as an independent rubric - tumors of unknown origin. The GCT tissue is represented by 3 cell lines: stromal fibroblast-like, mononuclear macrophages, giant multinucleated cells. Truly tumorous of them are only stromal fibroblast-like cells, the cells of other lines play an important role in the manifestation of the characteristic properties of GCT. Thus, histological examination reveals a complex of characteristic pathological changes in GCT, which, however, can be differently combined and have different severity even in within one large focus, which often makes differential histological diagnosis difficult, especially with a small unrepresentative histo- or cytobioptate. Therefore, it is necessary to perform an immunohistochemical study. Conclusion. Localization of GCT in the pelvis and in the sacrum is extremely rare. However, although only 6% of GCTs are found in the sacrum, these tumors are the second most common type of primary tumor of the sacrum. Due to the extremely rare occurrence of this tumor, despite the criteria for identifying them according to MSCT and MRI, which are quite clearly described in the literature, erroneous preoperative differentiation of this tumor is possible due to the lack of general surgeons, gynecologists and urologists in these departments, with a larger share the chances of such patients getting wary of detecting of GCT of the sacrum

giant cell tumor of the sacrum, clinical and morphological characteristics, ultrasound, MSCT, MRI, angiography, endovascular occlusion of afferent vessels, surgical treatment