Ann Rehabil Med.  2013 Apr;37(2):269-273. 10.5535/arm.2013.37.2.269.

Spinal Cord Injury due to the Giant Cell Tumor of the Second Thoracic Vertebra: A Case Report

• Kim HS
• Lee JE
• Jung SS
• Chon J
• Yoon DH
• Park YK
• Cho EH

• KMID: 2165781
• DOI: http://doi.org/10.5535/arm.2013.37.2.269

Abstract

Giant cell tumor (GCT) is a relatively rare neoplasm. In GCT, the bone affection of the axial skeleton is extremely rare. Most GCT arises in the meta-epiphyseal ends of the long bones. Its peak incidence is between 30 to 40 years of age. GCT is usually classified as benign, but shows locally aggressive behavior and may occasionally undergo a malignant transformation. The patients with GCT in the spine often complain of the lower back pains, as the tumors primarily involve the sacrum. We report a case of an adolescent female complaining of the upper back pain with a sudden weakness of the lower extremities, later diagnosed with the GCT of the T2 vertebra. The present patient showed American Spinal Injury Association Impairment Scale (AIS) D before the surgery, which changed to AIS E after the treatments including the surgery, radiation therapy and rehabilitation.

Keyword

Giant cell tumor; Spinal cord injuries

MeSH Terms

Adolescent
Back Pain
Female
Giant Cell Tumors
Giant Cells
Humans
Incidence
Low Back Pain
Lower Extremity
Sacrum
Skeleton
Spinal Cord
Spinal Cord Injuries
Spinal Injuries
Spine

Figure

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  Fig. 1 (A) Plain radiographs showed an osteolytic bony lesion at T2 vertebra (arrow), onset time of weakness, anterior-posterior view. (B) Lateral view. (C) Magnetic resonance imaging suggestive of giant cell tumor (arrow). There is signal change in the spinal cord at the T2 vertebra level suggesting a cord compression, T2 axial view. (D) T2 sagittal view.

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  Fig. 2 Magnetic resonance imaging of the operative site (arrow), 15 days after operation. (A) T2 axial view, (B) T2 sagittal view.

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  Fig. 3 The hematoxylin and eosin stained biopsy showed multinucleated giant cells with scant stroma (×400).

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  Fig. 4 Plain radiographs, 2 days after the operation. (A) Anterior-posterior view, (B) lateral view.

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  Fig. 5 Whole body positron emission tomography showing increased fluorodeoxyglucose (FDG) uptake in the T3 posterior aspect related to operative site (arrow), two months after the operation.

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