Biological characterization of human bone tumors (original) (raw)

1986, Journal of Cancer Research and Clinical Oncology

The biological behavior of giant cell tumors of bone often cannot be definitively evaluated by light and electron microscopical criteria. As DNA aneuploidy was found to be a highly sensitive marker of malignant cells, we have analyzed this descriptive parameter in 4 giant cell tumors of bone by flow cytometry. Three of the four cases were non-metastasizing giant cell tumors, the fourth was a clinically malignant neoplasm presenting extensive visceral metastases four years after first diagnosis. Neither light-nor electron microscopical findings provided unequivocal criteria for defining the biological dignity of the four tumors. DNA aneuploidies were identified in the metastasizing case only, whereas the three clinically benign tumors showed a unimodal euploid DNA distribution. Thus flow cytometric DNA analysis is an additional diagnostic tool for the detection of malignancy in giant cell tumors of bone. tumor cells32. The prognostic value of roentgenologic clas-sifications6, 27, 30 is also uncertain ll , 13. Giant cell tumors of bone are known to be far from uniform in their dignity. No general clinical or morphologic criteria are available for determining unequivocally the dignity of a lesion. Even the system of histologic grading by stromal atypia proposed by Ja£fe20 is only granted a limited and uncertain valueS, 15,29, although just these mononuclear stromal cells are identified as the true The problem of evaluation is of major importance for the main group of primary histologically "benign" giant cell tumors, as they are known to develop malignancy in quite a number of cases. Further, the phenomenon of socalled "benign" metastasizing giant cell tumors of boneS, 16, 2S, 31 has not been explained satisfactorily by conventional histologic and roentgenologic methods.