Ramos-Trujillo A, Miranda-González A, Míreles-Cano JN, Picado-Baca ML, Rodríguez-Messina AF

Language: Spanish
References: 8
Page: 94-99
PDF size: 617.69 Kb.

ABSTRACT

Giant cell tumors (GCT) are benign lesions, constituting 4% of bone lesions. They are located at the metaphysis of long bones. When these tumors locate in the spine, particularly at the lumbosacral region, their behavior is unpredictable. We present the case of a 20 years old, female patient, history of GCT 8 years ago, who begins with progressive paraparesis, abnormal sacral functions, sensory and motor deficit beyond T2 level. It was surgically treated in March 2014 after performing decompression with T1-T2 laminectomy excision of spinal tumor by 30% fixation intra spinal levels cervico-thoracic transfacetary C5-C6 and C7-T3-T4 transpedicular. Favorable postoperative evolution with toráprogressive recovery of strength and sensitivity was achieved. On June 26th the patient was submitted to an anterior approach total tumor resection with T1-T3 corpectomy, placement of telescopic box and allogenic bone graft; as well as resection of bilateral pleural infiltrates and left lung apex infiltrates. Currently, the patient has recovered strength and sensitivity and is capable to perform daily activities. Discussion. GCT location at the cervico-thoracic junction is uncommon. This location represents a surgical challenge because of the difficult approach and the risky surrounding anatomical structures, which are known to be benign tumors and their resection result in the cure of the patient. For this reason we consider important to report this case with successful treatment employed.

REFERENCES

1. Koopong Siribumrungwong. Unusual presentation of giant cell tumor originating from a facet joint of the thoracic spine in a child: a case report and review of the literature. Journal of Medical Case Reports 2013;7:178.

2. AA Lopes. Giant-cell tumour in the cervical spine: a case report. The Journal of the CCA 1989;33(2).

3. Bhupendra K.S. Sanjay Giant-cell Tumours of spine . The journal of bone and joint surgery .vol 75-B, No. 1 , January 1993.

4. Shih-Chieh Yang, Surgical Treatment for Giant Cell Tumor of theThoracolumbar Spine. Chang Gung Med J Vol. 29 No. 1January-February 2006.

5. Doita M, Miyamoto H, Nishida K,: Giant-cell tumor of the tendon sheath involving the thoracic spine. J Spinal Disord Tech 2005;18:445–448.

6. McDonald DJ, Sim FH, McLeod RA, Dahlia DC. Giant-cell tumor of bone. J Bone Joint Surg [Am] 1986;68-A:235- 42.

7. Bertoni F, Present D, Enneking WF. Giant cell tumor ofbone with pulmonary metastasis, J Bone Joint Surg 1985;67A:890-900.

8. Shikata J, Yamamuro T, Shimizu K, Shimizu K, KotouraY. Surgical treatment of giant-cell tumors. Clin Orthop1992; 278:29-36.