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Giant cell tumors of bone are locally aggressive, frequently harbor H3F3A p.G34W mutations, and rarely undergo malignant transformation. The pathogenesis of malignant transformation remains incompletely characterized.

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What is apoptosis? The Nomenclature Committee on Cell Death and numerous other pioneering cancer/p53 biologists use the terms "apoptosis" and "cell death" interchangeably, disregard the mind-numbing complexity and heterogeneity that exists within a tumor (intratumor heterogeneity), disregard the contribution of polyploid giant cancer cells (PGCCs; the root causes of therapy resistance and relapse) to this heterogeneity, and then propose novel apoptosis-stimulating anticancer strategies. This is shocking for the following three reasons. First, clinical studies reported since the 1990s have revealed that increased apoptosis in solid tumors is associated with increased tumor diversity and poor prognosis.

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Giant cell tumor of bone (GCTb), formerly also known as osteoclastoma, is a pathological entity that in veterinary medicine is still undefined and, probably, underdiagnosed. In humans, GCTb is recognized as a primary benign bone tumor, locally aggressive, with high local recurrence rates, with controversial histogenesis that can rarely progress or present as a malignant form. In pets, this tumor is still considered rare, though the possibility of underdiagnosis is significant.

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Case: We present an unusual case of metachronous multicentric giant cell tumor (GCT) of forearm bones in a 38-year-old male patient with an 8-year follow-up. The diagnosis was established by imaging and histopathology. He underwent multiple surgeries with extraperiosteal resection of lesions with free fibular grafts.

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An unusual case of multiple primary tumours involving the long bone and oral cavity.

Oral Maxillofac Surg

March 2025

Department of Oral & Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia.

Purpose Of Review: Multiple primary tumours (MPTs) are a rare clinical entity, and the co-occurrence of synchronous and metachronous MPTs in a single patient is even more exceptional. In the context of Erdheim-Chester Disease (ECD), an already uncommon disorder, the presentation of this disease in the oral cavity is notably rare. Furthermore, the simultaneous presence of ECD in the oral cavity and a Giant Cell Tumour (GCT) in a long bone has not been previously reported in medical literature.

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