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Giant-cell tumor of bone : ウィキペディア英語版 | Giant-cell tumor of bone
Giant-cell tumor of the bone (GCTOB) is a relatively uncommon tumor of the bone. It is characterized by the presence of multinucleated giant cells (osteoclast-like cells). Malignancy in giant cell tumor is uncommon and occurs in approximately 2% of all cases. However, if malignant degeneration does occur it is likely to metastasize to the lungs. Giant cell tumors are normally benign, with unpredictable behavior.〔Werner, M. (2006). Giant cell tumour of bone: morphological, biological and histogenetical aspects. Springer-Verlag , 30, 484-489〕 It is a heterogeneous tumor composed of three different cell populations. The giant-cell tumour stromal cells (GCTSC) constitute the neoplastic cells,〔Huang, l., Xu, J., Wood, D. J., & Zheng, M. H. (2000). Gene Expression of Osteoprotegerin Ligand, Osteoprotegerin, and REceptor Activator of NF-kB in Giant Cell Tumor of Bone. American Journal of Pathology , 156 (3), 761-767.〕 which are from an osteoblastic origin and are classified based on expression of osteoblast cell markers such as alkaline phosphatase and ostocalsin. In contrast, the mononuclear histiocytic cells (MNHC) and multinucleated giant cell (MNGC) fractions are secondarily recruited and comprise the non-neoplastic cell population. They are derived from an osteoclast-monocyte lineage determined primarily by expression of CD68, a marker for monocytic precursor cells.〔Thomas, D. M., & Skubitz, T. (2009). Giant-cell tumour of bone. Current Opinion in Oncology , 21, 338-344〕〔Werner, M. (2006). Giant-cell tumour of bone: morphological, biological and histogenetical aspects. Springer-Verlag , 30, 484-489.〕〔Wuelling, M., Delling, G., & Kaiser, E. (2003). The Origin of the Neoplastic Stromal Cell in Giant Cell Tumor of Bone. Human Pathology , 34, 983-993.〕 In most patients, the tumors are slow to develop, but may recur locally in as many as 50% of cases. ==Signs and symptoms==
Patients usually present with pain and limited range of motion caused by tumor's proximity to the joint space. There may be swelling as well, if the tumor has been growing for a long time. Some patients may be asymptomatic until they develop a pathologic fracture at the site of the tumor. They usually originate from the epiphysis of long bones but in rare cases they may arise from anterior arc of the ribs.〔Dehghan A, Moaddab AH, Eskandarlou M, Moeeni A. Anterior chest wall giant cell tumor. Gen Thorac Cardiovasc Surg. 2010 Jan;58(1):39-41.〕 The symptoms may include muscular aches and pains in arms, legs and abdominal pain. Patients may also experience nerve pain which feels like an electric shock.
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