Unusual Coexistence of Giant Cell Tumor and Small Bone Tuberculosis of the Hand - A Case Report
Journal Title: Global Journal of Medical and Clinical Case Reports - Year 2016, Vol 3, Issue 1
Abstract
Background: The coexistence of giant cell tumor (GCT) and metacarpal bone tuberculosis (TB) of the hand has never been described before in the English written literature. We report here a first observation. Case presentation: We report the case of a 49-year-old male who presented with severe pain in his left hand following a blunt trauma. A plain X-ray of the metacarpal bones showed a pathological fracture of the 4th metacarpal bone (diaphysis), and computerized tomography and magnetic resonance imaging studies confirmed the diagnosis of destructive (lytic) lesions. biopsy of the metacarpal lesion revealed a GCT, and tissue cultures were positive for mycobacterium tuberculosis (TB). He was treated by a standard 4-drug protocol of isoniazid, rifampicin, pyrazinamide and ethambutol for 2 months and an additional 6 months of isoniazid and rifampicin. He then underwent excision of the metacarpal lesion, and the pathological examination showed a GCT with cultures negative for TB. Conclusions: The correct diagnosis of this unique combination of pathologies (GCT and metacarpal bone TB) depended on a high index of clinical suspicion, referral to mycobacterial laboratory tests, careful histologic examination of tissue samples and especially radiomorphologic findings.
Authors and Affiliations
Gideon Charach, Itamar Grosskopf, Ronen Shteinvil, Michal Ehrnwald, Hila Nochomovitz, Lior Charach, Ori Rogowski
Keywords
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- EP ID EP243667
- DOI 10.17352/2455-5282.000029
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