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J Neurol Surg Rep 2016; 77(03): e144-e149
DOI: 10.1055/s-0036-1592082
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Multidisciplinary Approach to Management of Temporal Bone Giant Cell Tumor

Taija K. Nicoli
1   Department of Otorhinolaryngology–Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
,
Riste Saat
2   Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
,
Risto Kontio
3   Department of Maxillofacial Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
,
Anna Piippo
4   Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki Finland
,
Maija Tarkkanen
5   Cancer Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
,
Jussi Tarkkanen
6   Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
,
Jussi Jero
1   Department of Otorhinolaryngology–Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
› Author Affiliations
Further Information

Publication History

24 October 2015

26 July 2016

Publication Date:
30 September 2016 (online)

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Abstract

Background Giant cell tumors (GCTs) are rare osseous tumors that rarely appear in the skull.

Methods We review the clinical course of a 28-year-old previously healthy woman with a complicated GCT.

Results The reviewed patient presented with a middle cranial fossa tumor acutely complicated by reactive mastoiditis. Left tympanomastoidectomy was performed for drainage of the mastoiditis and for biopsies of the tumor. Due to the challenging tumor location, the patient was treated with denosumab, a fully humanized monoclonal antibody against receptor activator of nuclear factor kappa-B ligand, for 7 months, which resulted in significant preoperative tumor shrinkage. Extensive temporal craniotomy and resection of the tumor followed utilizing a temporomandibular joint total endoprosthesis for reconstruction. A recurrence of the tumor was detected on computed tomography at 19 months after surgery and treated with transtemporal tumor resection, parotidectomy, and mandible re-reconstruction.

Conclusion A multidisciplinary approach resulted in a good functional result and, finally, an eradication of the challengingly located middle cranial fossa tumor.

Keywords

giant cell tumor - temporal bone - multidisciplinary - management - surgery
 

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