May 7, 2012
A 54-year-old woman with slowly progressive pain in the right hemipelvis and radiation into the right leg for two months.
Sacral Giant Cell Tumor
- GCT is a locally aggressive neoplasm composed of osteoclastic giant cells.
- Second most common primary bone tumor of the sacrum after chordoma.
- Most occur in the 2nd to 5th decade of life, with marked female preponderance.
- Back pain of insidious onset is the most common presentation.
- Key Diagnostic Features: Geographic lytic lesion in a subchondral location. Plain radiograph and CT show narrow zone of transition, non-sclerotic margins, and absent matrix. Bone expansion and cortical breakthrough may be seen. Giant cell tumors are hypointense on T1WI and enhance after contrast administration. Areas of necrosis are common. Hemosiderin foci may be seen.
- DDx: Chordoma, osteosarcoma, osteoblastoma, Brown tumor of hyperparathyroidism, metastasis, multiple myeloma
- Surgery, arterial embolization pre-operatively or for unresectable cases
