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Giant cell tumor of the eleventh thoracic vertebra in a pediatric patient: an interesting case report and comprehensive literature review

Child's Nervous System volume 35, pages 553–557 (2019)Cite this article

Abstract

Introduction

Giant cell tumors of the mobile spinal column are very rare tumors, especially in the pediatric age group. Although they are benign tumors, they have locally aggressive growth pattern and high risk of recurrence.

Case presentation

We report a 15-year-old female patient with thoracic giant cell tumor who underwent percutaneous vertebroplasty and had cement extravasation into the spinal canal. Because of the deterioration of the patient’s neurological condition, total enbloc spondylectomy and cement excision were performed. She underwent instrumentation and fusion procedures in order to prevent spinal instability.

Conclusion

The main purpose of the treatment is gross total resection of the giant cell tumor. However, adjuvant methods such as denosumab should be added to the treatment protocol in patients who are older than 2 years old and can not undergo gross total resection due to tumor size and anatomic localization.

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References

  1. Balke M, Schremper L, Gebert C, Ahrens H, Streitbuerger A, Koehler G, Hardes J, Gosheger G (2008) Giant cell tumor of bone: treatment and outcome of 214 cases. J Cancer Res Clin Oncol 134(9):969–978

    Article  PubMed  CAS  Google Scholar 

  2. Ben Nsir A, Ben Said I, Badri M, Boughamoura M, Jemel H (2015) Giant cell tumor of the sixth thoracic vertebra: case report. Turk Neurosurg 25(3):475–478

    PubMed  Google Scholar 

  3. de Carvalho Cavalcante RA, Silva Marques RA, dos Santos VG, Sabino E, Fraga AC Jr, Zaccariotti VA, Arruda JB, Fernandes YB (2016) Lumbar spondylectomy for giant cell tumor after denosumab therapy. Spine (Phila Pa 1976) 41(3):E178–E182

    Article  Google Scholar 

  4. Kajiwara D, Kamoda H, Yonemoto T, Iwata S, Ishii T, Tsukanishi T, Ohtori S, Yamazaki M, Okawa A (2016) Denosumab for treatment of a recurrent cervical giant-cell tumor. Asian Spine J 10(3):553–557

    Article  PubMed  PubMed Central  Google Scholar 

  5. Sigwalt L, Bourgeois E, Eid A, Durand C, Griffet J, Courvoisier A (2016) A thoracic spinal bone giant cell tumor in a skeletally immature girl. A case report and literature review. Childs Nerv Syst 32(5):873–876

    Article  PubMed  Google Scholar 

  6. Yonezawa N, Murakami H, Kato S, Takeuchi A, Tsuchiya H (2017) Giant cell tumor of the thoracic spine completely removed by total spondylectomy after neoadjuvant denosumab therapy. Eur Spine J 26(Suppl 1):236–242

    Article  PubMed  Google Scholar 

  7. Elder BD, Sankey EW, Goodwin CR, Kosztowski TA, Lo SF, Bydon A, Wolinsky JP, Gokaslan ZL, Witham TF, Sciubba DM (2016) Surgical outcomes in patients with high spinal instability neoplasm score secondary to spinal giant cell tumors. Global Spine J 6(1):21–28

    Article  PubMed  Google Scholar 

  8. Luksanapruksa P, Buchowski JM, Singhatanadgige W, Rose PC, Bumpass DB (2016) Management of spinal giant cell tumors. Spine J 16(2):259–269

    Article  PubMed  Google Scholar 

  9. Charest-Morin R, Fisher CG, Varga PP, Gokaslan ZL, Rhines LD, Reynolds JJ, Dekutoski MB, Quraishi NA, Bilsky MH, Fehlings MG, Chou D, Germscheid NM, Luzzati A, Boriani S (2017) En bloc resection versus intralesional surgery in the treatment of giant cell tumor of the spine. Spine (Phila Pa 1976) 42(18):1383–1390

    Article  Google Scholar 

  10. Enneking WF, Spanier SS, Goodman MA (1980) A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res (153):106–120

  11. Boriani S, Bandiera S, Casadei R, Boriani L, Donthineni R, Gasbarrini A, Pignotti E, Biagini R, Scwab JH (2012) Giant cell tumor of the mobile spine: a review of 49 cases. Spine (Phila Pa 1976) 37(1):E37–E45

    Article  Google Scholar 

  12. Goldschlager T, Dea N, Boyd M, Reynolds J, Patel S, Rhines LD, Mendel E, Pacheco M, Ramos E, Mattei TA, Fisher CG (2015) Giant cell tumors of the spine: has denosumab changed the treatment paradigm? J Neurosurg Spine 22(5):526–533

    Article  PubMed  Google Scholar 

  13. Qi L, Li C, Wang N, Lian H, Lian M, He B, MD BG (2018) Efficacy of percutaneous vertebroplasty treatment of spinal tumors: a meta-analysis. Medicine (Baltimore) 97(3):e9575

    Article  Google Scholar 

  14. Martin C, McCarthy EF (2010) Giant cell tumor of the sacrum and spine: series of 23 cases and a review of the literature. Iowa Orthop J 30:69–75

    PubMed  PubMed Central  Google Scholar 

  15. Alfawareh MD, Shah ID, Orief TI, Halawani MM, Attia WI, Almusrea KN (2015) Pediatric upper cervical spine giant cell tumor: case report. Global Spine J 5(4):e28–e33

    Article  PubMed  Google Scholar 

  16. Kim SC, Cho W, Chang U, Youn SM (2015) Clinical outcome of treatment for patients with giant cell tumor in spine. J Korean Neurosurg Soc 58(3):248–253

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  17. Ma Y, Li J, Pan J, Yan W, Huang Q, Liu T, Yang X, Yang C, Xu W, Wei H, Xiao J (2016) Treatment options and prognosis for repeatedly recurrent giant cell tumor of the spine. Eur Spine J 25(12):4033–4042

    Article  PubMed  Google Scholar 

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Author information

Affiliations

  1. Department of Neurosurgery, Gaziantep Medical Park Hospital, Sehitkamil District, Ertugrul Street, 27000, Gaziantep, Turkey

    Kadir Oktay & Aslan Guzel

  2. Department of Radiology, Gaziantep Medical Park Hospital, Gaziantep, Turkey

    Ebru Guzel

  3. Department of Neurosurgery, Lokman Hekim Hospital, Ankara, Turkey

    Serkan Simsek

  4. Department of Neurosurgery, Bahcesehir University School of Medicine, İstanbul, Turkey

    Aslan Guzel

Authors
  1. Kadir Oktay
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  2. Ebru Guzel
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  3. Serkan Simsek
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  4. Aslan Guzel
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Corresponding author

Correspondence to Kadir Oktay.

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The authors declare that they have no conflict of interest.

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Oktay, K., Guzel, E., Simsek, S. et al. Giant cell tumor of the eleventh thoracic vertebra in a pediatric patient: an interesting case report and comprehensive literature review. Childs Nerv Syst 35, 553–557 (2019). https://doi.org/10.1007/s00381-018-3980-x

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  • DOI: https://doi.org/10.1007/s00381-018-3980-x

Keywords

  • Giant cell tumor
  • Pediatric
  • Mobile spinal column
  • Spondylectomy
  • Vertebroplasty
  • Cement extravasation