Giant cell tumor is a common oncological disease that is most often encountered by people aged 15 to 40 years. The disease is characterized by a benign course, and the tumor itself is formed in the tissues of the bones.
On the other hand, under the influence of some factors, malignant degeneration is possible, which is fraught with dangerous consequences. So what is an ailment and what symptoms are worth paying attention to?
What is osteoblastoclastoma? Structural features
A giant cell tumor is a rather specific structure that forms in bone tissues. It is known that osteoblastoclastoma consists of two types of cells: small mononuclear cells (round or oval cells with a light nucleus and a small amount of chromatin) and giant multinuclear cells (containing 20-30 nuclei and resemble normal osteoclasts in appearance; they are evenly distributed in the thickness of the neoplasm and are isolated from each other from friend).
In a section you can see that inside the tumor there is a soft tissue of brown color with traces of small hemorrhages (hemorrhages) and necrosis.
Classification of neoplasms
In modern medicine, such neoplasms are classified depending on the structure, form and other characteristics. If we talk about structural features, then a giant cell tumor can be:
- cellular (consists of small cells separated by incomplete bone partitions);
- cystic (the tumor is a cavity in the bone; it is filled with fluid, therefore, outwardly resembles a cyst);
- lytic (this is an aggressive type of tumor, the growth of which is accompanied by rapid destruction of bone tissue; a specific bone pattern cannot be determined).
During the diagnosis, attention is also paid to the location of the neoplasm. The tumor can be central (formed in the thickness of the bone) or peripheral (affects the superficial bone structures and periosteum).
In approximately 50% of cases, the neoplasm is located in the tissues of the bones around the knee joint. Often a tumor is found in the distal part of the radius. Nevertheless, osteoblastoclastoma can affect almost any bone, including the vertebrae, sacrum, tibia, femur and humerus, lower jaw. Sometimes the pathological process extends to the tendons and soft tissues.
The main causes of the development of the disease
Unfortunately, to date, the causes of the appearance and growth of the tumor are unknown. It is believed that there is a hereditary factor, especially if the laying and development of the child’s bone apparatus from the very beginning proceeded incorrectly.
Some experts argue that the likelihood of developing a giant cell tumor increases if the patient had inflammatory diseases that affect the bone and periosteum. Risk factors can also include frequent fractures and other injuries of the supporting apparatus.
What symptoms should I look for?
At the initial stages of development, a giant cell tumor rarely makes itself felt. The early signs include only aching pain that occurs periodically. More pronounced symptoms result from the intensive growth of the neoplasm.
Bone tissue begins to break down. Spontaneous fractures are possible at the site of localization of the neoplasm. As the tumor grows, a swelling appears under the skin, sometimes with a clear outline. On the outer integument in the area of the lesion, a network of vessels is drawn.
If the neoplasm is located close to the joint, then a partial or complete loss of its mobility is possible. Soreness also becomes more pronounced - discomfort disturbs the patient both during physical activity and at rest.
Malignant process and its symptoms
A giant cell tumor of the bone is considered relatively safe. Nevertheless, there is always a risk of malignant degeneration of the neoplasm. To date, the exact causes that trigger the process are unknown. Some scientists believe that the cause of everything is changes in the hormonal background and frequent injuries. There are doctors who claim that rebirth is the result of previous radiation therapy.
In any case, it is worthwhile to understand that a malignant neoplasm is dangerous. By the way, the process is accompanied by a number of symptoms that are worth paying attention to. There is an intensive growth of education. Often, the pathological process goes beyond the bone - in such cases, a giant cell tumor of soft tissues or tendons is formed.
During the examination, you can get ahead of the change in the structure of the neoplasm - it becomes lytic, the bone bridges between cells disappear, the contours of the cystic tumor become blurred. The diameter of the lesion increases - the disease is accompanied by intense destruction of bone tissue.
Diagnostic procedures
The presence of certain symptoms should prompt the doctor to think about the presence of cancer. Of course, a giant cell tumor requires careful diagnosis. After collecting an anamnesis, the patient is prescribed:
- A biochemical blood test, which allows not only to check the functioning of the whole organism, but also to detect markers indicating destruction of bone tissue.
- Mandatory is an X-ray examination. In the pictures, the doctor can see the tumor, evaluate its size, examine the condition of the bone. Equipment for such diagnostics is available in almost every hospital, and the cost of the procedure is affordable.
- The most informative method is magnetic resonance imaging (similarly accurate results can be obtained using computed tomography). The doctor has the opportunity to determine the size and structure of the tumor, evaluate the condition of the bone tissue, see the available metastases. Unfortunately, this is a rather expensive study.
- After a tumor is detected, a biopsy is recommended. During the procedure, the doctor carries out tissue sampling from the neoplasm - the samples are then sent to the laboratory. A biopsy analysis helps to check if the tumor contains malignant cells.
Based on the data obtained, the doctor can determine whether the neoplasm is dangerous, and then choose the most effective method of treatment.
Giant cell tumor: treatment
Immediately it is worth saying that therapy directly depends on the size of the neoplasm, the presence of a malignant process, the location of metastases, etc.
Removal of a giant cell tumor is necessary. During the operation, a resection is performed not only on the neoplasm, but also on the site of the affected bone. The remote part of the supporting apparatus is replaced with a prosthesis. With inflammation or infection of the tumor, the doctor may decide to amputate the entire limb. If metastases were found in the patient's body (for example, in the lung or liver), then partial removal of the affected tissue is performed.
Quite often, radiation therapy is included in the scheme. Such treatment is necessary if the tumor cannot be removed (for example, it has formed inside the femur, vertebra or sacrum). Irradiation is also carried out in the presence of a malignant process, even if during the surgical intervention it was possible to get rid of all pathological formations. In some cases, patients consciously refuse bone resection.
The choice of treatment method should be entrusted to the doctor. For the treatment of osteoblastoclastomas, remote gamma therapy, orthovoltage x-ray therapy, bremsstrahlung or electron radiation are used.
Giant cell tumor: prognosis for patients and possible complications
In most cases, the prognosis for patients is positive. Of course, the neoplasm needs to be removed, often together with the site of the affected bone. But relapses are rare.
But a malignant giant cell tumor is dangerous, because the disease is accompanied by the formation of metastases, which can be located in almost any organ. The surgeon is not always able to resect all neoplasms.