Giant cell tumor of the temporal bone with intratumoral hemorrhage

We report a case of hemorrhagic giant cell tumor (GCT) of the temporal bone in a 77-year-old woman. The patient suffered from sudden-onset headache and vomiting associated with left temporal hemorrhage. MRI revealed a left temporal extradural mass lesion expanding to the subtemporal fossa, showing strong hypointensity on T2-weighted imaging. Subsequent MRI revealed tumor growth with multiple cystic components at 1-month follow up. The tumor was found to be a GCT associated with recent intratumoral hemorrhage and abundant hemosiderin pigmentation. T2-weighted MRI of the GCT strongly supported hemosiderin deposition. Secondary formation of cystic components in the GCT can also reflect prior hemorrhage and indicate the progression of shape modification. A literature review revealed that hemosiderin deposition in this rare entity is not as rare as previously thought and that massive intratumoral hemorrhage may occur.