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Imaging of Giant Cell Tumor and Giant Cell Reparative Granuloma of Bone: Radiologic-Pathologic Correlation¹

¹ From the Departments of Radiologic Pathology (M.D.M., G.C.N.) and Orthopedic Pathology (F.H.G.), Armed Forces Institute of Pathology, 6825 16th St NW, Bldg 54, Rm M-133A, Washington, DC 20306; the Departments of Radiology and Nuclear Medicine, Uniformed Services University of Health Sciences, Bethesda, Md (M.D.M., D.J.F.); the Department of Radiology, National Naval Medical Center, Bethesda, Md (D.J.F.); the Department of Orthopedic Surgery, University of Miami School of Medicine, Miami, Fla (H.T.T.); the Department of Radiology, University of Maryland School of Medicine, Baltimore, Md (M.D.M.); and the Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.J.K.). Received April 9, 2001; revision requested April 17 and received May 17; accepted May 18. Address correspondence to M.D.M. (e-mail: murphey@afip.osd.mil).

The radiologic features of giant cell tumor (GCT) and giant cell reparative granuloma (GCRG) of bone often strongly suggest the diagnosis and reflect their pathologic appearance. At radiography, GCT often demonstrates a metaepiphyseal location with extension to subchondral bone. GCRG has a similar appearance but most commonly affects the mandible, maxilla, hands, or feet. Computed tomography and magnetic resonance (MR) imaging are helpful in staging lesions, particularly in delineating soft-tissue extension. Cystic (secondary aneurysmal bone cyst) components are reported in 14% of GCTs. However, biopsy must be directed at the solid regions, which harbor diagnostic tissue. These solid components demonstrate low to intermediate signal intensity at T2-weighted MR imaging, a feature that can be helpful in diagnosis. Multiple GCTs, although rare, do occur and may be associated with Paget disease. Malignant GCT accounts for 5%–10% of all GCTs and is usually secondary to previous irradiation of benign GCT. Treatment of GCT usually consists of surgical resection. Recurrence is seen in 2%–25% of cases, and imaging is vital for early detection. Recognition of the spectrum of radiologic appearances of GCT and GCRG is important in allowing prospective diagnosis, guiding therapy, and facilitating early detection of recurrence.

Index Terms: Bone neoplasms, 20.274, 20.3182, 30.3182, 40.3182 • Bone neoplasms, diagnosis, 40.11, 40.1211, 40.1214, 40.1216 • Giant cell tumor, 20.3182, 30.3182, 40.3182 • Granuloma, giant-cell reparative, 20.274

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