Daniel Refai1, Gavin P Dunn, Paul Santiago. 1. Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA. refaid@nsurg.wustl.edu
Abstract
BACKGROUND: Giant cell tumors are benign tumors of the bone that most commonly occur at the ends of the long bones; they are rarely found in the spine above the sacrum. The management of patients with giant cell tumors of the spine represents a challenge, and the clinical approach to this problem continues to evolve with improvements in surgical and adjunctive therapies. CASE DESCRIPTION: A 19-year-old woman with localized back pain and a spinal compression deformity was found to harbor a giant cell tumor of the T7 vertebral body. The patient was first treated with arterial embolization of the hypervascular region observed on angiography. Subsequently, the patient underwent a one-stage transthoracic T7 corpectomy followed by anterior spinal reconstruction and stabilization. Postoperatively, the patient's kyphotic deformity was corrected. To optimize local disease control, the patient underwent IMRT delivered to the site of tumor resection. She remains neurologically intact at 1 year postoperatively without evidence of disease recurrence. CONCLUSION: The literature and approaches to the management of spinal giant cell tumors are reviewed.
BACKGROUND:Giant cell tumors are benign tumors of the bone that most commonly occur at the ends of the long bones; they are rarely found in the spine above the sacrum. The management of patients with giant cell tumors of the spine represents a challenge, and the clinical approach to this problem continues to evolve with improvements in surgical and adjunctive therapies. CASE DESCRIPTION: A 19-year-old woman with localized back pain and a spinal compression deformity was found to harbor a giant cell tumor of the T7 vertebral body. The patient was first treated with arterial embolization of the hypervascular region observed on angiography. Subsequently, the patient underwent a one-stage transthoracic T7 corpectomy followed by anterior spinal reconstruction and stabilization. Postoperatively, the patient's kyphotic deformity was corrected. To optimize local disease control, the patient underwent IMRT delivered to the site of tumor resection. She remains neurologically intact at 1 year postoperatively without evidence of disease recurrence. CONCLUSION: The literature and approaches to the management of spinal giant cell tumors are reviewed.