Abstract
Introduction
Giant cell tumors are rare primary bone tumors. Multicentricity as well as spinal localization is extremely rare.
Case report
We report about a 64-year-old female patient presenting with history of three osseous and one pulmonal manifestation of a benign giant cell tumor that have manifested metachronously within 23 years. The two periphery bone and the one pulmonal manifestation were treated surgically with success. Now, a further osseous lesion occurred at the seventh vertebra of the thoracic spine and was treated by dorsal instrumentation and replacement of the seventh vertebra. Nine months later, local recurrence of this benign giant cell tumor developed at the thoracic spine and was treated with radiotherapy with a total dose of 45 Gy. Three months after salvage radiotherapy definite local progress occurred localized within the former radiation treatment field. Due to neurological deficits a laminectomy and a stabilization of the destroyed sixth vertebra with bone cement was carried out. Histopathological examination again showed benign giant cell tumor without suspicion of malignancy.
Conclusion
In the literature the use of radiation therapy remains an appropriate therapy option in benign giant cell tumors with minimal adverse sequelae if primary surgical treatment is not feasible or fails. In cases of definitive radiotherapy a total dose > 45 Gy should be discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Caudell JJ, Ballo MT, Zagars GK, Lewis VO, Weber KL, Lin PP, Marco RA, El-Naggar AK, Benjamin RS, Yasko AW (2003) Radiotherapy in the management of giant cell tumor of bone. Int J Radiat Oncol Biol Phys 57:158–165
Cummins CA, Scarborough MT, Enneking WF (1996) Multicentric giant cell of bone. Clin Orthop Relat Res 322:245–252
Hindman BW, Seeger LL, Stanley P, Forrester DM, Schwinn CP, Tan SZ (1994) Multicentric giant cell tumour: report of five new cases. Skeletal Radiol 23:187–190
Hug EB, Muenter MW, Adams JA, de Vries A, Rosenberg AE, Munzenrider JE (2002) 3-D-conformal radiation therapy for pediatric giant cell tumors of the skull base. Strahlenther Onkol 178:239–244
Kay RM, Eckardt JJ, Seeger LL, Mirra JM, Hak DJ (1994) Pulmonary metastasis of benign giant cell tumor of bone: Six histologically confirmed cases, including one of spontaneous regression. Clin Orthop Relat Res 302:219–230
Khan DC, Malhotra S, Stevens RE, Steinfeld AD (1999) Radiotherapy for the treatment of giant cell tumor of the spine: a report of six cases and review of the literature. Cancer Invest 17:110–113
Leggon RE, Zlotecki R, Reith J, Scarborough M (2004) Giant cell tumor of the pelvis and sacrum—17 cases and analysis of the literature. Clin Orthop Relat Res 423:196–207
Malone S, O’Sullivan B, Catton C, Bell R, Fornasier V, Davis A (1995) Long term follow-up of efficacy and safety of megavoltage radiotherapy in high-risk giant cell tumours of bone. Int J Radiat Oncol Biol Phys 33:689–694
Miszczyk L, Wydmanski J, Spindel J (2001) Efficacy of radiotherapy for giant cell tumor of bone: given either postoperatively or as sole treatment. Int J Radiat Oncol Biol Phys 49:1239–1242
Nair MK, Jyothirmayi R (1999) Radiation therapy in the treatment of giant cell tumor of bone. Int J Radiat Oncol Biol Phys 43:1065–1069
Oda Y, Miura H, Tsuneyoshi M, Iwamoto Y (1998) Giant cell tumor of bone: oncological and functional results of long-term follow-up. Jpn J Clin Oncol 28:323–328
O’Donnell RJ, Springfield DS, Motwani HK, Ready JE, Gebhardt MC, Mankin HJ (1994) Recurrence of giant-cell tumours of the long bones after curettage and packing with cement. J Bone Joint Surg Am 76A:1827–1833
Ogihara Y, Sudo A, Shiokawa Y, Takeda K, Kusano I (1994) Case report 862: multiple giant cell tumor of bone (symmetrical lesions in both humeral heads). Skeletal Radiol 23:487–489
Ozaki T, Liljenqvist U, Halm H, Hillmann A, Gosheger G, Winkelmann W (2002) Giant cell tumor of the spine. Clin Orthop Relat Res 401:194–201
Scully SP, Mott MP, Temple HT, O’Keefe RJ, O’Donnell RJ, Mankin HJ (1994) Late recurrence of giant-cell tumor of bone. J Bone Joint Surg Am 76A:1231–1233
Shikata J, Yamamuro T, Shimizu K, Shimizu K, Kotoura Y (1992) Surgical treatment of giant-cell tumors of the spine. Clin Orthop Relat Res 278:29–36
Sung HW, Kuo DP, Shu WP, Chai YB, Liu CC, Li SM (1982) Giant-cell tumor of bone: analysis of two hundred and eight cases in Chinese patients. J Bone Joint Surg Am 64A:755–761
Tubbs WS, Brown LR, Beabout JW, Rock MG, Unni KK (1992) Benign giant-cell tumor of bone with pulmonary metastases: clinical findings and radiologic appearance of metastases in 13 cases. Am J Roentgenol 158:331–334
Turcotte RE, Wunder JS, Isler MH, Bell RS, Schachar N, Masri BA, Moreau G, Davis AM; Canadian Sarcoma Group (2002) Giant cell tumor of long bone: a Canadian sarcoma group study. Clin Orthop Relat Res 397:259–270
Wulling M, Engels C, Jesse N, Werner M, Delling G, Kaiser E (2001) The nature of giant cell tumor of bone. J Cancer Res Clin Oncol 127:467–474
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Meyer, A., Bastian, L. & Bruns, F. Benign giant cell tumor of the spine: an unusual indication for radiotherapy. Arch Orthop Trauma Surg 126, 517–521 (2006). https://doi.org/10.1007/s00402-006-0174-x
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00402-006-0174-x