 Hello everyone, I'm Dr. J. Meenakshi doing my second year who's graduate in Department of Radio Diagnosis from Arupadai Viru Medical College and Hospital, Pondicherry. And I'm here to present my oral presentation on a case report on pliable giant cell tumour. Coming to the introduction, giant cell tumour of bone is also known as an osteoclastoma and it is very common and the giant cell tumour are mostly benign but it has a potential for malignant transformation. And the giant cell tumour of skull is very rare and it can be found as an incidental finding on imaging for some other cause. And the lesions are located usually in the middle cranial fossa affecting the following bones namely temporal, spinoid, petrocin and occipital bone of which the spinoid bone being the most commonly affected bone. And the common age group includes 20 to 40 years of age and it can affect both male and female. And here is a clinical history of a patient, 24 year old male with a history of diminished vision in the eyes and also on and off headache. And the patient is not a known case of hypertension and diabetes and he's not having any medical, surgical or trauma recent trauma history in the past. Coming to the radiological imaging, the patient was taken up for CT imaging and on axial non contract CT image. There is a soft tissue mass in the skull base involving the floor of the anterior cranial fossa and the sagittal bone window showing an expand cell lytic lesion, typically involving the clivus and the lesion is showing so purple appearance which is favouring for the giant cell tumour. And on coronal CT image bone window showing an expand cell lytic lesion with the so purple appearance. And the patient was also taken up for surgery, which showing the sagittal contest MRI imaging, showing a large lesion of size six cross four centimetre, which is centered on the clivus, and the lesion is also seen extending to the cellar and the paracella region. The patient was also been investigated for blood counts, which includes the complete blood count at the bicomical blood test, which is found to be normal, and the physical examination was also found to be normal. And on neurological examination patient was found to have optic nerve palsy. According to the management patient was taken up for surgery and the tumour was recited through endoscopic transnasal transpenoid method and the receptor tumour was sent for histopathology. And on histopathology, the tumour showed a fibrous collagenous tissue with scattered multi-nucleated giant cells within the stroma of spindle cells, based on the clinical history imaging and histopathological finding the diagnosis was concluded as giant cell tumour. As we discussed earlier, giant cell tumour of the skull and the clivus is very rare and it occurs in less than 5% of population and it is mostly found incidentally. And some patient may present with the symptoms like a headache, diminished vision or double vision, some may be asymptomatic. Patient when they are suspecting giant cell tumour of the skull should always be taken up for cerebral angiography because the tumour is supplied for multiple small vessels. The cerebral angiography before surgery can help in controlling bleeding during surgery because death may also occur due to massive uncontrolled bleeding. And identification of H3F3A mutation can also help in diagnosis of GCT of clivus because there are many other clivalations which help in differentiating this mutation can help in differentiating other clivalations. And the differentials can consider caudoma, scalbase caudoma and scalbase chondrosarcoma where the caudoma which is also centrally placed which is well circumscribed but the lesion has marginal sclerosis and chondrosarcoma here the lesion will have internal calcification. These are my references. Thank you.