Giant cell tumor of clivus: a rare case report and review of literature


  • Jannatul Ferdause Department of Radiation Oncology, Ahsania Mission Cancer and General Hospital, Dhaka, Bangladesh
  • Rubama Karim Department of Radiation Oncology, Ahsania Mission Cancer and General Hospital, Dhaka, Bangladesh
  • Anita Rahman Taposhi Department of Radiation Oncology, Ahsania Mission Cancer and General Hospital, Dhaka, Bangladesh
  • Qamaruzzaman Chowdhury Department of Radiation Oncology, Ahsania Mission Cancer and General Hospital, Dhaka, Bangladesh



Giant cell tumor, Clivus, Denosumab


Clival giant cell tumors (GCTs) are an extremely rare type of tumor, with only 13 cases reported to date. Despite being histologically considered benign, these tumors can be locally aggressive and have a high rate of local recurrence, as well as the potential for distant metastasis. Due to their rarity and the difficulty of treating them due to their critical location, the ideal treatment protocol for managing clival GCTs remains controversial. The present report describes a 22-year-old female who experienced ptosis on her right eye and visual disturbance for one month. Magnetic resonance imaging (MRI) revealed a large, heterogenous, lobulated mass lesion arising from the clivus, extending anteriorly and compressing the optic chiasm and optic tract, with both parasellar extension and extension into the sphenoid sinus. An endoscopic endonasal trans-sphenoidal procedure was performed to excise the lesion. Post-operative MRI revealed residual disease, so a revision surgery was done using a combined microscopic and endoscopic procedure. Following surgery, the patient was given Denosumab for one year as well as has been symptom-free for the past 18 months of follow-up. This report contributes to the limited literature on the GCTs involving the clivus.


Metrics Loading ...


Pai SB, Lalitha RM, Prasad K, Saraswathi GR, Harish K. Giant cell tumor of the temporal bone-a case report. BMC Ear, Nose and Throat Disorders. 2005;5(1):8.

Leonard J, Gökden M, Kyriakos M, Derdeyn CP, Rich KM. Malignant giant-cell tumor of the parietal bone: case report and review of the literature. Neurosurgery. 2001;48(2):424-9.

Weber AL, Hug EB, Muenter MW, Curtin HD. Giant-cell tumors of the sphenoid bone in four children: radiological, clinical, and pathological findings. Skull Base Surg. 1997;7(4):163-73.

Zorlu F, Selek U, Soylemezoglu F, Oge K. Malignant giant cell tumor of the skull base originating from clivus and sphenoid bone. J Neurooncol. 2006;76(2):149-52.

Cowan RW, Singh G, Ghert M. PTHrP increases RANKL expression by stromal cells from giant cell tumor of bone. J Orthop Res. 2012;30(6):877-84.

Wolfe JT 3rd, Scheithauer BW, Dahlin DC. Giant-cell tumor of the sphenoid bone. Review of 10 cases. J Neurosurg. 1983;59(2):322-7.

Kattner KA. Giant cell tumor of the sphenoid bone. Skull Base Surg. 1998;8(2):93-7.

Sharma RR. Craniospinal giant cell tumors: clinicoradiological analysis in a series of 11 cases. J Clin Neurosci. 2002;9(1):41-50.

Gupta R, Mohindra S, Mahore A, Mathuriya SN, Radotra BD. Giant cell tumour of the clivus. Br J Neurosurg. 2008;22(3):447-9.

Sasagawa Y, Tachibana O, Shiraga S, Takata H, Kinoshita E, Nojima T et al. Secondary malignant giant cell tumor of the clivus: case report. Clin Neurol Neurosurg. 2012;114(6):786-8.

Iacoangeli M. Endoscopic endonasal approach for the treatment of a large clival giant cell tumor complicated by an intraoperative internal carotid artery rupture. Cancer Manag Res. 2013;5:21-4.

Roy S, Joshi NP, Sigamani E, Malik A, Sharma MC, Mohanti BK et al. Clival giant cell tumor presenting with isolated trigeminal nerve involvement. Eur Arch Otorhinolaryngol. 2013;270(3):1167-71.

Agrawal, A., et al., Giant cell tumor of the clivus with presence of epithelioid histiocytes. Asian J Neurosurg. 2014;9(1):48-9.

Shibao S, Toda M, Yoshida K. Giant cell tumors of the clivus: Case report and literature review. Surgical Neurol Int. 2015;6(25):S623-7.

Patibandla MR, Thotakura MK. Clival giant cell tumor-A rare case report and review of literature with respect to current line of management. Asian J Neurosurg. 2017;12(1):78-81.

Satapathy A. Giant cell tumor at the clivus: Not an area 51. Neurol India. 2018;66(3):861-4.

Yamamoto M. Giant cell tumor of the sphenoid bone: long-term follow-up of two cases after chemotherapy. Surg Neurol. 1998;49(5):547-52.

Chawla S. Safety and efficacy of denosumab for adults and skeletally mature adolescents with giant cell tumour of bone: interim analysis of an open-label, parallel-group, phase 2 study. Lancet Oncol. 2013;14(9):901-8.

Inoue A. Role of Denosumab in Endoscopic Endonasal Treatment for Juvenile Clival Giant Cell Tumor: A Case Report and Review of the Literature. World Neurosurg. 2016;91:674.e1-6.

Thomas D. Denosumab in patients with giant-cell tumour of bone: an open-label, phase 2 study. Lancet Oncol. 2010;11(3):275-80.






Case Reports