Giant cell tumors of the sacrum treated with intralesional resection and radiotherapy: a case series and review of the literature

Abstract

Background Giant cell tumors (GCT) are relatively rare neoplasms, representing less than 5% of all bone tumors. They are most frequent in the extremities and are characterized by their local aggression. Treatment is typically surgery alone. Localization in the sacrum is rare, and here radiation therapy (RT) may be a useful tool for tumor management because of the difficulty of achieving accurate wide margins of surgical resection. We report a series of four cases treated by intralesional resection and RT. Patients and methods From 1996 to 2007, four patients with histologically proven sacral giant cell tumors were treated with intentional intralesional surgery and RT in our institution. Three patients were female and one was male. Median age was 35.5 years (range 19-53).Results After a median follow-up of more than 11 years (range 32-144 months), all the patients are alive and free of disease. Pain and neurological symptoms disappeared after treatment. No severe cases of acute or late toxicity have been reported. No radiological signs of progression were observed. Conclusion We propose RT be considered as a standard coadjuvant treatment after intralesional surgery for sacral GCT, where efficient local control without severe toxicity is advisable.