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SEER Inquiry System - Report
Produced: 11/27/2024 11:29 AM
Question 20170029
Inquiry Details
References:
#1: ICD-O-3
#2: WHO Class Soft Tissue & Bone
Question:
Reportability--Bone: Are giant cell tumors (GCT) of the bone that metastasize to the lung reportable? See Discussion.
Discussion:
Patient had radical resection of pelvic giant cell tumor of bone in August 2012. Final diagnosis clarified that no features to suggest a frankly malignant giant cell tumor were identified.
July 2013 left upper lobe nodules were removed and found to be consistent with multifocal metastatic lung involvement with a previous pelvic giant cell tumor of bone. However, the pathology report comment specifies there are no histological high-grade features to suggest a malignancy:
While SINQ 20091087 may apply, these metastases clearly arrived in the lung by hematogenous spread. The previous SINQ note refers to a case where the implants/metastases can seed the surrounding pelvic and abdominal structures by rupture of the tumor or intraoperative tumor spillage. That type of spread is not quite the same as the current case showing tumor cells leaving the primary tumor/site and travelling through the blood to implant in the lungs.
Answer:
This case is not reportable. According to the WHO Classification of Bone Tumors, pulmonary metastases from GCTs are "very slow-growing and are thought to represent pulmonary implants that result from embolization of intravascular growths of GCT. Some of these benign pulmonary implants can regress spontaneously. A small number, however, exhibit progressive enlargement and can lead to the death of the patient." The pathologist for this case is very clear that no malignancy was found in the lung or in the bone.
