A newborn with giant cell tumor of occipital bone: case report

Giant cell tumors of bone (GCTB) are commonly benign neoplasms and characterized by regional progressive and destructive lesions. They have the malignant potential and capacity to metastasis. Incidents of GCTB are reported in 20% of all benign, 5% of all malignant bone tumors and pediatric cases account for less than 5% of all them. The first line treatment strategy for GCTBs is surgical resection. A male baby presented at our hospital on his 10th day of life suffering from respiratory distress and persistent vomiting. His blood and urine panels were within normal parameters, cranial magnetic resonance imaging (CMRI) was planned to evaluate his condition. The CMRI report noted a ‘suspected 4x3 cm contrasted bone-derived malignant looking mass at the left posterior fossa of the cranium’. The biopsy confirmed: ‘A grade I-II giant cell tumor of bone’. Surgical resection was not possible because of the location of the mass and its proximity to blood vessels but chemotherapy was the one strategy available in this particular case. The chemotherapy regimen consisted of cisplatin 1 mg/kg/day (1-3 days) and doxorubicin 1 mg/kg/day (1,2 days) and was applied four times every month. Using CMRI, we noted a reduction in mass of more than 50% after two sessions and complete regression after four sessions. The patient was given regular follow-ups with no evidence of recurrence and co-morbidity for the next 60 months. We recommend that chemotherapy is a successful alternative strategy when surgical resection, radiotherapy, and other therapies are not indicated for GCTBs.