CASE OF THE MONTH: ABSTRACTS

摘要

January 2007, Case 1. A 27-year-old woman presented with a 5-month history of headache, hoarseness and swallowing dysfunction, which begun during the East trimester of her second pregnancy. Neurological examination demonstrated right-sided deafness and dysfunction of the right VII, IX, X and XI cranial nerves. Computed tomography (CT) and magnetic resonance imaging (MRI) disclosed a right temporal bone mass with invasion of the jugular foramen. A massive calcified portion of the tumor significantly compressed the brain stem. The patient underwent surgical resection of the tumor. Microscopic examination disclosed two well-demarcated components within the tumor. The predominating components were highly cellular areas consisting of ovoid-to-spindled cells and numerous osteoclast-like multinucleated giant cells that frequently contained cytoplasmic vacuoles. Minor lobulated areas consisted of round or polygonal-shaped cells with grooved, ovoid, hyper-chromatic nuclei, surrounded by an eosinophilic chondroid matrix. Calcifications were mainly found in the minor lobulated components of the tumor. The diagnosis was a chondroblastoma of the petrous portion of the temporal bone. Cranial chondroblastomas are extremely rare. Misinterpretation of the histology of chondroblastomas may occur because the multinucleated giant cell containing stroma may be much more predominating than tumor components revealing the typical chondroid differentiation with chondroblasts and a chondroid matrix, making the giant cell tumors the principal differential diagnosis in such cases.