An Unusual Presentation of Giant Cell Tumor of the Tibia in a Skeletally Immature Patient.

INTRODUCTION: Giant cell tumors (GCTs) are locally aggressive tumors that principally affect the epiphysis of long bones. Histologically, these tumors consist of three types of cells: Osteoclast-like multinucleated giant cells, round mononuclear cells resembling mononucleocytes, and spindle-shaped round fibroblast-like stromal cells. Radiographically, the tumors appear osteolytic and radiolucent without a sclerotic border. The tumor rarely occurs in pediatric age group. Its incidence in pediatric patients varies from 1.8 to 7.5%. CASE REPORT: A 15-year-old girl presented to us with the complaints of pain in the left knee of 3months' duration and inability to squat. Radiographic imaging was done which showed lytic lesion involving the proximal tibia and showing cortical destruction. The lesion was graded as a Campanacci Grade 3 tumor. The patient was taken up for surgery and an extended curettage was performed, and the cavity was packed with bone cement. The patient was asymptomatic at the end of 18-month follow-up and was continuing her normal daily activities. CONCLUSION: GCT of the bone is extremely rare in skeletally immature patients. This particular case highlights the need for keeping the diagnosis of GCT at the periphery of one's vision when dealing with pediatric patients presenting with osteolytic lesion at the epimetaphysis of long bones.

A rare case of Glomus Tumor of the Thenar Eminence of the Hand Misdiagnosed as Carpal Tunnel Syndrome.

INTRODUCTION: Glomus body is an apparatus present in the skin at the arterio-venous junction whose main function is to control the body temperature. Hyperplasia of the glomus body results in an entity called glomus tumor. Masson described this entity first in 1924, as a tumor of the neuromyoarterial body. Due to its symptoms, it is of ten misdiagnosed and wrongly treated which adds burden to the patient. CASE REPORT: We report a rare case of glomus tumor presenting at an unusal site that is the thenar eminence of the palm. He had been misdiagnosed and wrongly treated for carpal tunnel syndrome. The tumor was surgically excised and diagnosis was confirmed by histopathological studies. We present this case for its rarity, unusual presentation and it being a cause for misdiagnosis. CONCLUSION: The common sites of glomus tumors are the finger tips or under the nail. Many such cases have been reported in the literature. We present this case because of its unusual site of presentation and a cause of misdiagnosis. The authors feel that this report could offer a learning experience to orthopaedic surgeons when similar patients present to them to avoid adding burden to the already anxious patient.