A Case Report of a Sacral Giant Cell Tumor Treated With Block Resection and Lumbo-Pelvic Fixation

Abstract

Giant cell tumors (GCT) are benign but locally aggressive neoplasms composed of osteoclast-like giant cells and fusiform to ovoid mononuclear stromal cells. GCT generally comprise 5-10% of all benign bone tumors; they appear most frequently between the second and third decades of life. These tumors are also distributed throughout the vertebral column. Approximately half of all spinal GTCs develop in the sacrum. Many cases remain clinically silent and are discovered incidentally during the study of minor trauma. Symptomatic tumors often mimic other common spinal pathologies. Imaging studies ideal for diagnosis are CT and MRI. The techniques used in the treatment of giant cell tumors are curettage or intralesional surgery, block resection, radiotherapy, and chemotherapy. Herein, we report on a 23-year-old female patient diagnosed with a tumoral mass in the anterior part of the sacrum, suggestive of GCT. The lesion was completely excised in two consecutive surgeries, and lumbopelvic fixation was performed with favorable immediate postoperative results. Careful surgical planning with a multi-disciplinary approach leading to block resection still remains the most viable option for the treatment of vertebral GCT.

Mexican Multicenter Experience of Metastatic Spinal Disease

“…Multidisciplinary management benefits patients and offers the best diagnostic tools and treatment types such as three-dimensional (3D) printing. This allows for the creation of patient-specific anatomical models based on their imaging data, as well as the use of telemedicine [44][45][46]. These models provide a tangible representation of the patient's spine, including the metastatic lesions, enabling surgeons to understand the complex anatomy and plan the surgical approach more effectively.…”

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“…The most common prognostic scoring systems are the Tomita score [7], the Tokuhashi score [8], and recently the NOMS algorithm [9] (Figure 14).…”

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