[Malignant giant cell tumor of the soft tissues].

giant cell tumors of the neck occur very rarely. Although such tumors usually arise from cartilaginous neck structures, they sometimes originate in the soft tissues. Soft-tissue giant cell tumors of the neck are likely to be more aggressive and have a higher mortality rate than are tumors arising from the cartilaginous larynx. An aggressive use of available treatment modalities, including radiotherapy, is generally warranted. There has been only limited information published about giant cell tumors arising in the soft tissues of the neck. 1,2 This report details the case of a woman with such a tumor, which developed 2 months after she underwent total thyroidectomy. The pathology of the mass is described, the patient's treatment regimen is provided, and a brief review of the literature on giant cell tumors of the neck is presented. A 42-year-old woman was initially evaluated because of a 5-month history of a left anterior midline neck mass. Medical history was otherwise unremarkable. Physical examination showed a mass that was 2 cm in diameter, mobile, and slightly painful. Subsequent ultrasound examination revealed a solid mass. Results of fine-needle aspiration were nondiagnostic. Suppressive therapy with levothyroxine was initiated but was unsuccessful. After an intraoperative examination of the thyroid gland revealed many suspicious nodules on both sides of the gland, a total thyroidectomy was performed. Pathologic examination of the thyroid gland showed nodular hyperplasia with microscopic fol-licular adenoma. No vascular invasion was noted. The postoperative course was at first unremarkable. The patient returned 2 months after the thyroidec-tomy because of a new anterior midline neck mass. She reported no symptoms of pain, tenderness, dysphagia, or shortness of breath. Examination of the mass showed it to be 2 cm in diameter, firm, and mobile; the mass did not move with deglutition. The differential diagnosis included a stitch granuloma or a new thyroid mass in retained tissue. Intraoperatively, the mass was found located in the soft tissues of the neck, anterior to the platysma muscle. The mass did not involve any of the thyroid cartilages or muscles and did not appear to be associated with the surgical wound. The mass was widely excised. Pathology Pathologic examination of the second mass revealed a well-circumscribed tumor surrounded by fibrous tissue; no thyroid or lymphoid tissue was identified. The tumor was divided by fibrous bands into lob-ules and consisted of numerous osteoclast-type giant cells with abundant eosinophilic to amphophilic cyto-plasm and multiple vesicular …