Giant Cell Tumor of Dorsal Vertebrae-A Rare Case Report with Review of Literature

Abstract

A 32-year-old well-built male presented to the Orthopaedics clinic with major complaints of low backache with both lower limbs weakness and disturbed bladder/ bowel habits. An osteolytic lesion was seen at tenth thoracic vertebra with anterior compression on the spinal cord on radio-imaging. Giant cell tumor (GCT) of dorsal vertebral body is an uncommon entity and total en bloc excision is difficult. Complete intralesional tumor excision with reconstruction was performed. Histopathological examination was suggestive of GCT. Our patient is doing well after one year of follow-up, without any signs of recurrence of the tumor and is ambulant with support. We discuss in brief about incidence, presentation and various treatment modalities available for spinal GCT.

Contiguous Lumbar Vertebral Involvement with Vertebral Collapse in Giant Cell Tumor: A Usual Tumor with an Unusual Presentation

“…1 There is equal gender predilection and age group affected is 20–45 years. 2 3 Our patient was 28 years old, which corroborates with the age of GCT. GCT involving vertebrae is an uncommon occurrence and only a few such cases have been reported.…”

“…This feature helps to differentiate GCT from other spinal neoplasms such as metastases, lymphomas, and chordoma that usually demonstrate hyperintense signal on T2-weighted MR images. [2][3][4]6,7 The symptoms are caused by nerve root compression leading to radiculopathy and sensory and motor deficit of variable severity, as in our case. It is a locally aggressive tumor, as also described in this case.…”

“…In such scenarios, treatment options include local radiation therapy, chemo-embolization, or systemic therapies such as bisphosphonates, sunitinib, calcitonin, or denosumab. 2 3 5 9 10 In this case, the patient was started on adjuvant therapy with denosumab. Subsequently, she will be followed for clinical improvement and tumor size regression, based on which a decision for the extent of surgery will be taken.…”

“…GCT involving vertebrae is an uncommon occurrence and only a few such cases have been reported. [2][3][4][5] In this case, contiguous involvement of adjacent vertebrae is an unusual finding, which posed a diagnostic challenge on radiology. Contiguous involvement of vertebra more commonly occurs in infections such as tuberculosis.…”

“…It is a locally aggressive tumor, as also described in this case. 2,3,8 The importance of correct diagnosis lies in directed management. The treatment of GCT is complete surgical excision, as the tumor rarely metastases.…”