The patient was a 77-year-old woman with hypertension and no other history of interest. She presented with generalized edema, oliguria and weight gain, associated with asthenia and malaise of months of evolution.

Giant cell tumours (GCT) are usually benign, locally aggressive tumours. They tend to occur in long bones and rarely in small bones, with an incidence rate of 1.2 to 2.4% in the bones of the foot. The objective is to present a unique case in the literature of a GCT that only affected the first cuneiform. We present the case of a 35-year-old male patient seen at Hospital General de México (HGM) with seven months history of pain and increased volume in the medial region of the right foot, with X-ray and MRI images consistent with GCT in first cuneiform of the right foot. The excisional biopsy confirmed GCT. The definitive treatment consisted of curettage, cryotherapy with nitrogen and heterologous bone graft placement. Evolution was satisfactory, with no pain, no volume increase, normal gait and radiographic bone graft integration. Follow-up was at six years.

The chromatin remodeling factor chromodomain helicase DNA-binding protein 4 (CHD4) is a core component of the nucleosome remodeling and deacetylase (NuRD) complex. Due to its important role in DNA damage repair, CHD4 has been identified as a key determinant in cancer progression, stem cell differentiation, and T cell and B cell development. Accumulating evidence has revealed that CHD4 can function in NuRD dependent and independent manner in response to DNA damage. Mutations of CHD4 have been shown to diminish its functions, which indicates that interpretation of its mutations may provide tangible benefit for patients. The expression of CHD4 play a dual role in sensitizing cancer cells to chemotherapeutic agents, which provides new insights into the contribution of CHD4 to tumor biology and new therapeutic avenues.