Malignant giant cell tumor of tendon sheath

Abstract
A benign, but aggressive, giant cell tumor of tendon sheath developed over a period of 20 years into a metastasizing, histologically malignant giant cell tumor. Ultrastructure of the malignant tumor showed the same five cell types as described in giant cell tumors of tendon sheath. Even the same crystals were identified in the osteoblast-like and osteoclast-like cells. It therefore appears reasonable to assume that giant cell tumors of tendon sheath indeed are neoplasms with a malignant potential and not an inflammatory reaction of synovial cells as previously suggested. Both the benign and malignant tumors seem to be of mesenchymal derivation with partial osseous differentiation. No ultrastructural similarities with fibrous histiocytoma were apparent.