Case 23
HISTORY: The patient is a 40-year-old man with a history of being treated for tumor in the lower end of left radius. Four years later came for follow up with complaints of dyspnea. X ray of chest showed a radio-opaque shadow in the left mid-zone. FNA from the lung lesion are presented in Figs. 1 & 2.
Note: Pictures were taken from a color print of the photomicrograph using Intel PC camera.
Responses may be sent to:
Krishnan R. Iyengar, MD, DNB
iyengar_kris@satyam.net.in
JIPMER Hospital, Pondicherry, India
Fig. 1: Pap. (x 300)
Fig. 2. MGG. (x 300)
Diagnosis: Metastatic giant cell tumor.
Responses:
Total : 16
Metastatic giant cell tumor: 11
Osteosarcoma: 3
Chondrosarcoma:1
Metastatic synovial sarcoma:1
Discussion: The resection this patient had earlier was for a giant cell tumor of the radius. Since the original tumor was histologically benign with no evidence of vascular emboli, the possibility of "Benign Metastasizing Giant cell Tumor" was considered ( Ref. AFIP fascicle on Bone tumors). There was no histopathology available for the lung lesion. The forearm tumor recurred, but still showed no overt evidence of anaplasia.
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