Giant Cell Tumor of Bone in Patients 55 Years and Older

Cory J. Broehm, Carrie Y. Inwards, Alyaa Al-Ibraheemi, Doris E. Wenger, Sarah M. Jenkins, Long Jin, Andre M. Oliveira, Riyam T. Zreik, Jodi Carter, Jennifer M. Boland, Karen J. Fritchie

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives Most giant cell tumors of bone (GCTs) occur in patients aged 20 to 40 years. We analyzed features of GCT in patients 55 years or older. Methods GCTs were examined for fibrosis, matrix, cystic change, histiocytes, mitoses, and necrosis. Clinical/radiologic data were collected. Results Thirty-four (5%) of 710 GCTs occurred in patients older than 55 years (14/20 male/female; 56-83 years) in long bones (n = 24), vertebrae (n = 6), pelvis (n = 3), and metacarpal (n = 1). Imaging was classic in 26 of 27 cases; one case appeared malignant. Morphologic patterns included fibrosis (n = 29), bone formation (n = 19), cystic change (n = 8), necrosis (n = 8), foamy histiocytes (n = 7), and secondary aneurysmal bone cyst formation (n = 1). Mitoses ranged from 0 to 18 per 10 high-power fields. Six recurred; one patient developed metastasis. Four of five cases harbored H3F3A mutations. Conclusions GCTs in patients 55 years or older share pathologic characteristics with those arising in younger adults. Fibrosis and reactive bone are common, potentially leading to diagnostic confusion in this population. No histologic features correlate with adverse outcome.

Original languageEnglish (US)
Pages (from-to)222-233
Number of pages12
JournalAmerican Journal of Clinical Pathology
Volume149
Issue number3
DOIs
StatePublished - Feb 17 2018

Fingerprint

Giant Cell Tumor of Bone
Histiocytes
Mitosis
Osteogenesis
Fibrosis
Necrosis
Aneurysmal Bone Cysts
Bone and Bones
Metacarpal Bones
Pelvis
Cystic Fibrosis
Young Adult
Spine
Neoplasm Metastasis
Mutation
Population

Keywords

  • Bone tumors
  • Elderly
  • Giant cell tumor of bone
  • H3F3A

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Broehm, C. J., Inwards, C. Y., Al-Ibraheemi, A., Wenger, D. E., Jenkins, S. M., Jin, L., ... Fritchie, K. J. (2018). Giant Cell Tumor of Bone in Patients 55 Years and Older. American Journal of Clinical Pathology, 149(3), 222-233. https://doi.org/10.1093/ajcp/aqx155

Giant Cell Tumor of Bone in Patients 55 Years and Older. / Broehm, Cory J.; Inwards, Carrie Y.; Al-Ibraheemi, Alyaa; Wenger, Doris E.; Jenkins, Sarah M.; Jin, Long; Oliveira, Andre M.; Zreik, Riyam T.; Carter, Jodi; Boland, Jennifer M.; Fritchie, Karen J.

In: American Journal of Clinical Pathology, Vol. 149, No. 3, 17.02.2018, p. 222-233.

Research output: Contribution to journalArticle

Broehm, CJ, Inwards, CY, Al-Ibraheemi, A, Wenger, DE, Jenkins, SM, Jin, L, Oliveira, AM, Zreik, RT, Carter, J, Boland, JM & Fritchie, KJ 2018, 'Giant Cell Tumor of Bone in Patients 55 Years and Older', American Journal of Clinical Pathology, vol. 149, no. 3, pp. 222-233. https://doi.org/10.1093/ajcp/aqx155
Broehm CJ, Inwards CY, Al-Ibraheemi A, Wenger DE, Jenkins SM, Jin L et al. Giant Cell Tumor of Bone in Patients 55 Years and Older. American Journal of Clinical Pathology. 2018 Feb 17;149(3):222-233. https://doi.org/10.1093/ajcp/aqx155
Broehm, Cory J. ; Inwards, Carrie Y. ; Al-Ibraheemi, Alyaa ; Wenger, Doris E. ; Jenkins, Sarah M. ; Jin, Long ; Oliveira, Andre M. ; Zreik, Riyam T. ; Carter, Jodi ; Boland, Jennifer M. ; Fritchie, Karen J. / Giant Cell Tumor of Bone in Patients 55 Years and Older. In: American Journal of Clinical Pathology. 2018 ; Vol. 149, No. 3. pp. 222-233.
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abstract = "Objectives Most giant cell tumors of bone (GCTs) occur in patients aged 20 to 40 years. We analyzed features of GCT in patients 55 years or older. Methods GCTs were examined for fibrosis, matrix, cystic change, histiocytes, mitoses, and necrosis. Clinical/radiologic data were collected. Results Thirty-four (5{\%}) of 710 GCTs occurred in patients older than 55 years (14/20 male/female; 56-83 years) in long bones (n = 24), vertebrae (n = 6), pelvis (n = 3), and metacarpal (n = 1). Imaging was classic in 26 of 27 cases; one case appeared malignant. Morphologic patterns included fibrosis (n = 29), bone formation (n = 19), cystic change (n = 8), necrosis (n = 8), foamy histiocytes (n = 7), and secondary aneurysmal bone cyst formation (n = 1). Mitoses ranged from 0 to 18 per 10 high-power fields. Six recurred; one patient developed metastasis. Four of five cases harbored H3F3A mutations. Conclusions GCTs in patients 55 years or older share pathologic characteristics with those arising in younger adults. Fibrosis and reactive bone are common, potentially leading to diagnostic confusion in this population. No histologic features correlate with adverse outcome.",
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AU - Oliveira, Andre M.

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