FIGURE 2:
  1. First histopathologic exam with diagnostic of “Suggestive of Paraganglioma” showing, a mass consisting of strands of rounded cells, with eosinophilic cytoplasm, oval nuclei and some areas of hemorrhage and necrosis.
  2. CD68 positive marker showing macrophage activity and some interpose multinucleated giant cells, in the first biopsy.
  3. H3.3G34W negative marker showing no activity for GCTB 4 years ago.
FIGURE 3: New histopathological features of the surgical specimen 4 years after. This tumor was characterized by proliferation of vascular spaces and fibroblastic cells with discrete collagen fibers and areas of hemorrhage surrounded by a large number of multinucleated giant cells, some with disorganized nuclei (A, B, C and D - asterisk ), others similar to Touton giant cells (E - arrow ), and different areas with osteoid material (arrow ). A large proliferation of xanthomatous-looking cells was also observed (F ), positive for periodic acid–Schiff staining (PAS, x200).