Spinal giant cell-rich osteosarcoma-diagnostic dilemma and treatment strategy: A case report

Abstract

BACKGROUND Giant cell-rich osteosarcoma (GCRO) is a rare histological variant of osteosarcoma. Spinal GCROs are extremely rare, with challenging diagnosis and management. Herein, we present a case of spinal GCRO at T2, which was not diagnosed in initial biopsy but after T2 corpectomy. We detailed the clinical course, management strategy, and outcome after a 4-year follow-up. CASE SUMMARY A 17-year-old female patient presented with back pain followed by ascending paresthesia. Spinal computed tomography (CT) and magnetic resonance imaging (MRI) revealed a collapsed T2 vertebra with an enhancing osteolytic mass. CT-guided biopsy showed inconclusive morphology. Pathology from T2 corpectomy revealed GCRO. The patient subsequently received neoadjuvant chemotherapy followed by salvage operation of T2 costotransversectomy with grossly-total resection adjuvant chemoradiation. Upon treatment completion, she had complete GCRO remission. The 4-year follow-up spinal MRI showed no tumor recurrence. CONCLUSION Spinal GCRO poses unique challenges in obtaining sufficient tissue diagnosis and complete surgical removal. However, long-term local control of spinal GCRO is possible following complete resection and adjuvant chemoradiation

Giant cell‐rich osteosarcoma: A match pair analysis of 11 new cases and literature review of 56 patients

“…Literature search revealed 56 cases of GCRO published between 1986 and 2022 in a total of 34 studies, with 36 cases reported from Asia (64%; Table 3). 10–12,18–50 Mean age was 26 years (range, 5–73 years) and 28 were males (50%). Localizations were reported as follows: Femur (38%; n = 21; 10 times distal, 8 times diaphyseal, 2 times proximal, 1 time unspecified), tibia (27%; n = 15; 14 times proximal, 1 time diaphyseal), mandible ( n = 5), vertebrae C6 to T6 ( n = 4), maxilla ( n = 2), proximal fibula ( n = 2), proximal ulna ( n = 2), foot ( n = 2; first metatarsal, medial cuneiform), 11th rib ( n = 1), skull base ( n = 1), and distal radius ( n = 1).…”