Singh Jagdeep, Bahadur Raj, Garg Sorabh, Rajpal Karan, Chopra Karan
Department of Orthopaedics, Guru Gobind Singh Medical College and Hospital, Faridkot, India.
Int J Surg Case Rep. 2020;72:45-51. doi: 10.1016/j.ijscr.2020.05.033. Epub 2020 May 29.
Giant cell tumor (GCT) of the spine is uncommon but most aggressive benign tumor of the spine with unpredictable outcome. The purpose of this study was to report on a surgical treatment for the cases of GCT (C2, T4 and C7-T1). The spine is not a common site for a Benign GCT, with a 2.5% incidence in the sacrum and 2.9% in the vertebrae above the sacrum. In the cervico-thoracic spine, the incidence is extremely low and has been reported very less in the literature.
This study was conducted on 3 cases of GCT of the spine and evaluated the outcome of different treatment modalities retrospectively. All the cases were treated with intralesional surgical resection but only one developed recurrence.
Cord compression and neurological deficits of varying grades was observed in all the cases. All patients also presented with clinical as well as radiological instability. Overall results were satisfactory, as all patients were symptom-free postoperatively. One out of the three cases had tumour recurrence and needed repeat intervention.
Giant cell tumour of cervico-thoracic spine is a rare entity and should be managed Surgically with en bloc/extralesional resection but due to risk of surrounding neurovascular structures damage they are managed by marginal resection therefore since total resection is not possible there are high chances of recurrences, Hence require close monitoring and follow up for early diagnosis and appropriate management.
脊柱巨细胞瘤（GCT）并不常见，但却是脊柱最具侵袭性的良性肿瘤，其预后难以预测。本研究旨在报告GCT（C2、T4和C7 - T1）病例的手术治疗情况。脊柱并非良性GCT的常见部位，在骶骨的发生率为2.5%，在骶骨以上椎体的发生率为2.9%。在颈胸段脊柱，其发生率极低，文献报道也很少。
本研究对3例脊柱GCT病例进行了回顾性分析，评估了不同治疗方式的结果。所有病例均采用病灶内手术切除，但仅有1例复发。
所有病例均观察到不同程度的脊髓压迫和神经功能缺损。所有患者还存在临床及影像学不稳定。总体结果令人满意，因为所有患者术后均无症状。3例中有1例肿瘤复发，需要再次干预。
颈胸段脊柱巨细胞瘤是一种罕见疾病，应采用整块/病灶外切除进行手术治疗，但由于存在损伤周围神经血管结构的风险，故采用边缘性切除进行处理，因此由于无法进行全切除，复发几率较高，所以需要密切监测和随访以早期诊断并进行适当处理。
