Expansile bone lesions of the vertebra.

Kumar, Rajendra; Guinto, Faustino C.; Madewell, John E.; David, Ronald B.; Shirkhoda, Ali

doi:10.1148/radiographics.8.4.3175086

Cited by 32 publications

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“…Although GCTs exhibit a propensity for aggressive local recurrence, there are few reports of metastases or recurrence from GCT of the spine. Additionally, GCTs are difficult to determine due to the low incidence of these lesions (2,4).…”

Section: Discussionmentioning

confidence: 99%

“…GCTs rarely occur in the spine, with 2-5% of tumors found in the spine above the sacrum (2,3). When occurring in the spine, these tumors most commonly present with localized pain and swelling of the affected side, and may also result in neurological deficit (3,4).In this study, the authors present an extremely rare case of GCT occurring in the axial skeleton, involving the sacrum, thoracic spine and parieto-occipital skull in more than 15 years of follow up. The study was approved by the Institutional Review Board (IRB) for Human Subjects Research and Ethics Committees of Hanyang University Guri Hospital, Korea.…”

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confidence: 83%

Section: Introductionmentioning

confidence: 99%

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The rare case of giant cell tumor occuring in the axial skeleton after 15 years of follow-up: Case report

et al. 2011

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Abstract. The majority of giant cell tumors (GCTs) occur in the ends of the long bones. The presence of more than one GCT in the axial skeleton is rare. A GCT is capable of remaining clinically latent following treatment and becoming active a number of years later. We report an extremely rare case of GCT occurring in the axial skeleton, involving the sacrum, thoracic spine and parieto-occipital skull in more than 15 years of follow-up. IntroductionGiant cell tumors (GCTs) are benign tumors commonly occurring at the ends of the long bones, representing approximately 5% of bone tumors (1). GCTs rarely occur in the spine, with 2-5% of tumors found in the spine above the sacrum (2,3). When occurring in the spine, these tumors most commonly present with localized pain and swelling of the affected side, and may also result in neurological deficit (3,4).In this study, the authors present an extremely rare case of GCT occurring in the axial skeleton, involving the sacrum, thoracic spine and parieto-occipital skull in more than 15 years of follow up. The study was approved by the Institutional Review Board (IRB) for Human Subjects Research and Ethics Committees of Hanyang University Guri Hospital, Korea. Case reportIn March 1993, a 24-year-old male without a significant past medical history presented with a several-month history of localized pain in the right buttock area. There was induration on the buttock and a firm, palpable mass.Neurological examination revealed mild weakness of the flexor hallucis longus and flexor digitorum longus with grade 4/5 power. The patient experienced diminished sensation in the perineal region, and sphincter tone was slightly diminished. Radiographs revealed a large, osteolytic lesion involving almost the entire sacrum (Fig. 1). Computed tomography (CT) also revealed a destructive sacral mass involving almost the entire sacrum below the S1 vertebral body. T2-weighted magnetic resonance imaging (MRI) showed an expansile soft tissue mass with a heterogeneous signal density. The tumor infiltrated into the spinal and sacral canal, and into the presacral area above S2 (Fig. 2). The technetium-99m methylene diphosphonate whole-body bone scan revealed an abnormally high uptake in the sacral region (Fig. 3). Metastases were not found. To prevent an improper diagnosis or a delay in treatment occurring, open biopsy was performed from the posterior aspect of the sacrum, and histopathological examination revealed numerous multinucleated giant cells within a background of scant stroma consistent with GCT (Fig. 4).With the goal of pain relief, tumor resection and prevention of further neurological deterioration, the patient underwent high sacral amputation using a staged anterior and posterior approach. In the first stage, the anterior procedure with a transperitoneal approach was performed. The anterior aspect of the tumor was exposed, and internal iliac and middle sacral vessels were ligated. The anterior osteotomy was performed through the lower border of the S1 vertebral body at the level just belo...

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The rare case of giant cell tumor occuring in the axial skeleton after 15 years of follow-up: Case report

et al. 2011

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“…Sanjay et al (1) The radiographic characteristics of spinal giant cell tumors are considered to be a round or oval extrapleural mass with shell-like calcification of the marginal lesions and any mineralized matrix is absent. Extension into the posterior elements and paraspinal soft tissues and associated vertebral collapse are often apparent (6).…”

Section: Discussionmentioning

confidence: 99%

Giant Cell Tumor of the Thoracic Spine Presenting as a Posterior Mediastinal Tumor with Benign Pulmonary Metastases: A Case Report

Kim

Rho

Bahn

et al. 2010

J Korean Soc Radiol

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Giant cell tumor (GCT) is a benign neoplasm that usually involves the metaphysis and epiphysis of long bones. Although the spine is the fourth leading location of GCT, most of these lesions occur in the sacrum, followed by the thoracic, cervical and lumbar vertebrae (1). GCT of bone is a benign, but potentially aggressive lesion that shows local recurrence and metastases. Metastatic lung disease rarely originates from a benign tumor, but this can occur from GCT of bone (2). The incidence of lung metastases from a histologically proven GCT has range from 1% to 9% (3). To the best of our knowledge, this is the first reported case of a thoracic spinal GCT that simulated a mediastinal mass, along with dispaying benign pulmonary metastases, in the medical literature. Here we present a case of a histologically proven thoracic spinal GCT that presented as a mediastinal tumor with pulmonary metastases. Case ReportA 29-years-old man was admitted to the hospital for evaluation of active pulmonary tuberculosis. He had been in close contact with a person who was recently diagnosed with active pulmonary tuberculosis. The patient had developed a mild cough and back pain, but there were no other respiratory symptoms. The physical examination and the results of the laboratory tests, including examination for acid-fast bacilli in sputum smears, were unremarkable. Chest radiography showed a huge soft-tissue mass in the right upper mediastinum (Fig. 1A). Moreover, several sharply marginated, round nodules were observed in both lungs (Fig. 1A). The up- Giant cell tumor of bone is a benign, but potentially aggressive lesion that can show local recurrence and metastases. We report here on a case of a 29-year-old man who presented with an incidentally found mediastinal mass. Chest radiography and computed tomography showed a huge mediastinal mass with bilateral pulmonary nodules and the diagnosis of giant cell tumor with benign pulmonary metastasis was confirmed. To the best of our knowledge, this is the first reported case of primary thoracic spinal giant cell tumor manifesting as a huge mediastinal mass with pulmonary metastases.

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“…Other locations reported in the literature are the distal radius (8%), the sacrum (6%), and the proximal humerus (5%) [31][32][33]. Rarely, GCTB could involve the proximal femur, the vertebra, the distal tibia, the proximal fibula, the hand, and the foot [34][35][36]. Extremely rarely, this tumor could affect the greater trochanter [30].…”

Section: Radiological Appearancementioning

confidence: 99%

Giant cell tumor of bone: current review of morphological, clinical, radiological, and therapeutic characteristics

Georgiev

Slavchev²,

Dimitrova³

et al. 2014

J Clin Exp Invest

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ÖZETKemiğin dev hücreli tümörü erişkinlerdeki tüm primer kemik tümörlerinin %5'ini oluşturur ve kemik tümörlerinin en güç ve yoğun araştırılanıdır. Bu durum büyük ölçüde tekrarları öngörmeye izin veren tek tip klinik, radyografik, histolojik ve morfolojik özelliklerinin olmayışı nedeniyledir. Dünya Sağlık Örgütü tarafından agresif potansiyeli olan malign bir lezyon olarak sınıflandırılan kemiğin dev hücreli tümörü akciğere metastaz yapar ve malign dejenerasyon veya çok merkezli lokalizasyon gösterir. Tümör genellikle uzun kemiklerde oluşur, ancak alışılmadık lokalizasyonlarda da olabilir. Yaygın semptomu tümör bölgesindeki artan ağrıdır. Standart tedavi küretajdan geniş rezeksiyona kadar değişir ve değişik onkolojik ve fonksiyonel sonuçlar doğurur. Tümör evresine bakılmaksızın, cerrahiyi takip eden ilk 2-3 yılda tekrarlama riski yüksektir. Bu yazıda bu patolojik teşekkülün morfolojik, klinik, radyolojik ve tedavi özellikleri ile ayırıcı tanısı tartışılmıştır.Anahtar kelimeler: Kemiğin dev hücreli tümörü, tanı, tedavi, derleme ABSTRACTGiant cell tumor of bone accounts for about 5% of all primary bone tumors in adults and is still one of the most obscure and intensively examined tumors of bone. This largely results from the lack of uniform clinical, radiographic, histological or morphological aspects that allow prediction of recurrence. Classified by the World Health Organization as "an aggressive, potentially malignant lesion", the giant cell tumor of bone could give lung metastases, could undergo malignant degeneration or could have multicentric localization. It usually develops in long bones but can also occur in unusual locations. The common presenting symptom is increasing pain at the tumor site. Standard treatment ranges from curettage to wide resection, with reports of varying oncological and functional results. The recurrence rate is high during the first 2-3 years after surgery regardless of pre-operative tumor stage. Herein, we discuss the morphological, clinical, radiological, and therapeutic characteristics of this pathologic entity as well as its differential diagnosis. J Clin Exp Invest 2014; 5 (3): 475-485

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Expansile bone lesions of the vertebra.

Abstract: Vertebral expansion may be caused by both benign and malignant disease processes. Recognition of such lesions on radiographs facilitates accurate diagnosis in many cases.

Cited by 32 publications

References 0 publications

The rare case of giant cell tumor occuring in the axial skeleton after 15 years of follow-up: Case report

The rare case of giant cell tumor occuring in the axial skeleton after 15 years of follow-up: Case report

Giant Cell Tumor of the Thoracic Spine Presenting as a Posterior Mediastinal Tumor with Benign Pulmonary Metastases: A Case Report

Giant cell tumor of bone: current review of morphological, clinical, radiological, and therapeutic characteristics

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