Symplastic/pseudoanaplastic giant cell tumor of the bone

Judy Sarungbam, Narasimhan Agaram, Sinchun Hwang, Chao Lu, Lu Wang, John Healey, Meera Hameed

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective: Giant cell tumor of bone (GCTB) is a locally aggressive primary bone tumor. Its malignant counterpart is quite rare. Rarely, a conventional GCTB shows marked nuclear atypia, referred to as symplastic/pseudoanaplastic change, which can mimic sarcomatous transformation. Recently, somatic driver mutations of histone H3.3 exclusively in H3F3A have been described in GCTB. We report a series of 9 cases of GCTB with symplastic/pseudoanaplastic change, along with analysis of H3F3A variants. Materials and methods: Nine cases of GCTB with symplastic change were identified. Clinico-radiological features, morphological features, and immunohistochemical stain for Ki-67 stain were reviewed. H3F3A variants were also analyzed using Sanger sequencing. Results: Histologically, conventional giant cell tumor areas with scattered foci of markedly atypical cells were seen in all of the cases and all showed rare if any Ki-67 labeling. One patient had received denosumab treatment and another radiation therapy. Radiological features were characteristic of conventional GCTB. Mutation in H3F3A (p.Gly34Trp [G34W]) was found in 6 of the 7 cases. Clinical follow-up ranged from 6 to 208 months. Local recurrences were seen in 4 cases (44 %). Conclusions: GCTB with symplastic/pseudoanaplastic change is an uncommon variant of conventional GCTB, which can mimic primary sarcoma or sarcomatous transformation. These tumors possess the same missense mutation in histone H3.3 as conventional GCTB.

Original languageEnglish (US)
Pages (from-to)929-935
Number of pages7
JournalSkeletal Radiology
Volume45
Issue number7
DOIs
StatePublished - Jul 1 2016
Externally publishedYes

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Giant Cell Tumor of Bone
Histones
Coloring Agents
Giant Cell Tumors
Mutation
Missense Mutation
Sarcoma
Neoplasms
Radiotherapy
Bone and Bones
Recurrence

Keywords

  • Giant cell tumor of bone
  • Symplastic/pseudoanaplastic

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Sarungbam, J., Agaram, N., Hwang, S., Lu, C., Wang, L., Healey, J., & Hameed, M. (2016). Symplastic/pseudoanaplastic giant cell tumor of the bone. Skeletal Radiology, 45(7), 929-935. https://doi.org/10.1007/s00256-016-2373-z

Symplastic/pseudoanaplastic giant cell tumor of the bone. / Sarungbam, Judy; Agaram, Narasimhan; Hwang, Sinchun; Lu, Chao; Wang, Lu; Healey, John; Hameed, Meera.

In: Skeletal Radiology, Vol. 45, No. 7, 01.07.2016, p. 929-935.

Research output: Contribution to journalArticle

Sarungbam, J, Agaram, N, Hwang, S, Lu, C, Wang, L, Healey, J & Hameed, M 2016, 'Symplastic/pseudoanaplastic giant cell tumor of the bone', Skeletal Radiology, vol. 45, no. 7, pp. 929-935. https://doi.org/10.1007/s00256-016-2373-z
Sarungbam, Judy ; Agaram, Narasimhan ; Hwang, Sinchun ; Lu, Chao ; Wang, Lu ; Healey, John ; Hameed, Meera. / Symplastic/pseudoanaplastic giant cell tumor of the bone. In: Skeletal Radiology. 2016 ; Vol. 45, No. 7. pp. 929-935.
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