A Case Report of Giant Cell Tumor of the Occipital Bone

ABSTRACT

PURPOSE: Giant cell tumors of the bone are rare, locally aggressive lesions that primarily affect the epiphysis of the long bones in young adults. These tumors occur very rarely on the skull, principally in the sphenoid and temporal bones. The occipital bone is an unusual site. We report a rare case of a giant cell tumor of the occipital bone with a review of the relevant literature. METHODS: A 7-year-old boy presented with a mass of the right occipital area, which was accompanied by localized tenderness and mild swelling. The mass was first recognized approximately 1 year earlier and grew slowly. There was no significant history of trauma. The physical examination revealed a non-mobile and non-tender bony swelling on the occipital region. The neurological evaluation was normal. The serial skull radiography and CT scan showed focal osteolytic bone destruction with a bulged soft tissue mass in the right occipital bone. The patient underwent a suboccipital craniectomy and a complete resection of the epidural mass. The lesion was firm and cystic. The mass adhered firmly to the dura mater. RESULTS: The postoperative clinical course was uneventful, and the patient was discharged 5 days later. The histopathology report revealed scattered multinucleated giant cells and mononuclear stromal cells at the tumor section, and the giant cells were distributed evenly in the specimen, indicating a giant cell tumor. CONCLUSION: Giant cell tumors are generally benign, locally aggressive lesions. In our case, the lesion was resected completely but a persistent long term follow up will be needed because of the high recurrence rate and the possible transformation to a malignancy.