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Cervical spine tenosynovial giant cell tumor involving the atlantoaxial joint in a pediatric patient with medulloblastoma

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Abstract

Tenosynovial giant cell tumor (TGCT) is a benign condition that arises from tendon sheaths, synovium, or bursae and is classified according to the site of involvement (intra-articular versus extra-articular) and pattern of growth (localized versus diffuse). The diffuse form tends to present as peri-articular masses and are locally aggressive. It usually presents as a mono-articular process affecting larger joints. Spinal involvement is extremely rare, particularly the cervical spine. In this case report, we present a pediatric case of spinal TGCT involving the C1-C2 joint which was incidentally detected in a 13-year-old girl undergoing surveillance for medulloblastoma recurrence. Although spinal TGCT is a benign condition, it remains a diagnostic challenge, which specific to our case can raise the concern for malignancy or metastasis. We also described a percutaneous biopsy approach using a spring-loaded blunt tip coaxial needle to avoid inadvertent vascular injury. The imaging features of spinal TGCT and biopsy approach for atlantoaxial lesion are discussed together with a comprehensive review of the literature.

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Acknowledgements

The authors thank Dr. Ng Wai Fu for making contributions to this paper.

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Authors and Affiliations

  1. Department of Diagnostic & Interventional Radiology, Kwong Wah Hospital, Kowloon, Hong Kong

    Waylon Wai Chung Tsui

  2. Department of Radiology, Hong Kong Children Hospital, Kowloon, Hong Kong

    Kin Fen Kevin Fung, Pui Kwan Joyce Chan, Ming Keung Ernest Yuen & Yee Ling Elaine Kan

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  1. Waylon Wai Chung Tsui
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Correspondence to Waylon Wai Chung Tsui.

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Tsui, W.W.C., Fung, K.F.K., Chan, P.K.J. et al. Cervical spine tenosynovial giant cell tumor involving the atlantoaxial joint in a pediatric patient with medulloblastoma. Skeletal Radiol 51, 1317–1324 (2022). https://doi.org/10.1007/s00256-021-03952-z

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  • DOI: https://doi.org/10.1007/s00256-021-03952-z

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