Giant cell tumor (GCT) of bone is a generally benign but locally aggressive neoplasm that most commonly affects the epiphysis of long bones in young adults, while involvement of the cranial bones is exceedingly rare, particularly in the pediatric population. Calvarial GCTs pose significant diagnostic challenges because their clinical and radiologic features overlap with other lytic skull lesions. We report a rare case of a pediatric giant cell tumor arising from the calvarium that presented with progressive scalp swelling and localized pain. Radiologic evaluation demonstrated an expansile osteolytic lesion involving the skull with cortical destruction. Surgical excision of the lesion was performed with adequate margins, followed by histopathological examination together with clinico-radiological correlation supported the diagnosis of giant cell tumor of bone in the absence of immunohistochemistry and molecular testing. Although immunohistochemistry tests were not available, diagnosis was established based on clinicopathological correlation. The patient had an uneventful postoperative recovery with no evidence of recurrence during follow-up. This case highlights the importance of considering giant cell tumor in the differential diagnosis of pediatric calvarial lesions despite its rarity. Early recognition and complete surgical excision remain critical for optimal outcomes and for preventing local recurrence. Reporting such uncommon presentations contributes to the limited literature on cranial GCTs in children and helps improve diagnostic awareness among clinicians.
Engidaw et al. (Sat,) studied this question.