Clinical and imaging characteristics of giant cell tumor in patients aged 18 and below.
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OBJECTIVE: To investigate the clinical and imaging characteristics of giant cell tumors (GCT) in patients aged 18 and under. METHODS: This retrospective study analyzed clinical and imaging data from 12 patients aged 18 and below with histopathologically confirmed GCT, treated at xxx hospital from January 2015 to December 2023. Collected data included patient demographics, clinical presentation, anatomical tumor location, and imaging features from X-rays, CT scans, and MRI. Histopathological examination and immunohistochemistry were performed to confirm diagnoses and assess tumor characteristics. RESULTS: The study included 12 patients (6 males, 6 females) with a mean age of 15.5 years. The most common presenting symptoms were localized pain and swelling. The proximal tibia was the most frequently affected site. Imaging studies consistently showed osteolytic bone destruction with features such as eccentric growth patterns, sclerotic margins, periosteal reaction, and cystic changes. Pathological fractures were noted in five patients. MRI provided detailed insights into the internal architecture of the tumors, including fluid-fluid levels. Histopathology confirmed the presence of multinucleated giant cells within a stromal background. Immunohistochemical analysis showed that RANKL, VEGF, MMP-9, and Ki-67 were variably expressed across cases, with statistically higher expression levels of RANKL and MMP-9 observed in patients with pathological fractures and open epiphyseal plates, respectively. CONCLUSION: GCT in patients aged 18 and under presents distinct clinical and imaging features that are crucial for accurate diagnosis and effective treatment planning. Recognizing these characteristics is essential for managing this rare but significant bone tumor in the pediatric and adolescent population.