Giant‐cell tumor of the sphenoid and temporal bones

Giant‐cell tumor of bone rarely occurs in the skull. There have been only 14 previously reported benign tumors involving the sphenoid and only 11 found in the temporal bone. While considered benign tumors, they are very aggressive and have a tendency to local recurrence and late malignant change with metastasis. These tumors are predominant in females and occur in the second and third decade of life. Treatment is usually with curettage and/or radiation. It is such a rare tumor that no one individual or group has had extensive clinical experience with the lesion. The purpose of this paper is to present the case of a 29‐year‐old physician's wife who developed frontal headache and diplopia in January of 1966. Skull films revealed a lytic lesion in the left petrous pyramid. After two incomplete removals and a full course of radiation, the tumor progressed to involve the sphenoid, clivus and a portion of the right petrous apex. A middle fossa approach, as described by House, was used to obtain a total removal of the tumor. Four and one half years post surgery, she is free of symptoms clinically and radiographically. In view of the fact that these tumors usually recur within two years this probably represents a cure.