Tenosynovial giant cell tumor of the cervical spine: a case report

Abstract

Introduction Tenosynovial giant cell tumors (TSGCTs) generally occur in the limb joints, and only rarely in the spine. This case report describes a patient with TSGCT of the spine at C1-C2, which was treated surgically and diagnosed as TSGCT. Case presentation A 32-year-old woman with a 4-month history of neck pain and numbness in both upper extremities was referred to our department. Magnetic resonance imaging (MRI) revealed a neoplastic lesion extending from the left epidural space to the erector spinae muscles at the C1-C2 vertebral level, which was isointense on T1-weighted images, heterogeneously hypointense on T2-weighted images, and showed heterogeneous enhancement on gadopentetate dimeglumine (Gd-DTPA)-enhanced T1-weighted images. Computed tomography showed no findings suggestive of bone destruction of the vertebral body. Because the neurological symptoms were progressive, total macroscopic resection of the tumor was performed via a posterior approach. Histopathological examination of the resected specimen revealed the diagnosis of TSGCT. Improvement of the both the neck pain and upper-extremity numbness was noted postoperatively. An MRI obtained 6 months after the surgery revealed no evidence of tumor recurrence and the postoperative course was uneventful. Discussion TSGCT of the upper cervical spine (C1-C2) is rare, and this is the tenth reported case. If a tumor is heterogeneously hypointense on T2-weighted MRI, which reflects hemosiderosis, the possibility of this tumor should be considered in the differential diagnosis.

Tenosynovial giant cell tumours of the upper and lower cervical spine: two case reports

“…Large load bearing joints, such as the hips and knees, are most involved [ 1 , 3 ]. Involvement of the axial skeleton is rare, with only ~80 cases having been reported in the literature [ 1 , 8 ]. When present in the spine, 52% of lesions are found in the cervical spine while 29% of lesions occur in the lumbar spine and the remaining 17% of lesions are found in the thoracic spine [ 5 ].…”

“…In general, gross total resection is recommended for TSGCTs due to their locally aggressive nature and the considerable risk for recurrence (20%) [ 1 , 5 – 7 ]. In recurrent cases or those which are deemed inoperable, immunotherapy/chemotherapy, radiation therapy and radiological surveillance are used [ 2 , 4 , 8 ].…”

“…Gross total resection is recommended for all TSGCTs due to their locally aggressive nature and the subsequent risk of joint instability from bone erosion and of neurological deficit from spinal cord compression [ 1 , 2 , 5 – 7 ]. However, in recurrent or inoperable cases, immunotherapy, radiation therapy and radiological surveillance are used [ 2 , 4 , 8 ]. 9 of the 13 previous upper cervical cases underwent gross total resection, while 3 were managed conservatively with serial MRI scans and 1 underwent immunotherapy [ 2 , 3 , 5 – 14 ].…”

Tenosynovial giant cell tumor involving the cervical spine: A case report

“…According to Wang et al [ 4 ], the cervical spine is the most common site of spinal TGCTs, followed by the lumbar spine and thoracic spine[ 4 ]. TGCTs of the spine usually originate from the synovium of the facet joints, grow diffusely outside the joints, and invade nearby vertebrae[ 5 ].…”

Tenosynovial Giant Cell Tumor of the Retropharynx: A Case Report With Literature Review

“…[3][4][5] About 60 cases involving the TMJ have been reported in the English literature. 6 In other parts of this region, including the neck, 7,8 cervical spine, [9][10][11] clinoid, 12 and retropharynx, TSGCT appears to be even rarer. Here, we report a case of a TSGCT in the retropharynx to strengthen clinicians' understanding of this disease.…”