Shen Jun, Jiao Jian, Zhong Nanzhe, Guan Yu, Wang Da, Xu Jinhui, Dai Zeyu, Ma Xiaoyu, Yang Minglei, Zhou Haohan, Wu Zhipeng, Yang Xinghai, Liu Tielong, Wei Haifeng, Xiao Jianru
Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China.
Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China.
J Clin Neurosci. 2022 Dec;106:145-151. doi: 10.1016/j.jocn.2022.10.018. Epub 2022 Oct 29.
This study aimed to characterize giant cell tumor of the tendon sheath (GCTTS) in spine more fully and further validate the therapeutical effect of surgcial resection for treating this neoplasm.
Patients diagnosed with spinal GCTTS and received surgical resection in our hospital between January 2009 and September 2021 were identified retrospectively. The clinical data and radiological images were summarized and the clinical outcomes of patients with a follow-up period of more than 12 months were analyzed.
Thirty patients with benign GCTTS and one with malignant GCTTS were included. Preoperative radiological images were available in 28 of 30 benign cases. Benign lesions were revealed as soft tissue masses centering on the facet joint with osteolytic bone destruction in 26 patients on CT, and as prevertebral or intramuscular masses without bone erosion in 2. MRI showed the signal of isointensity or hypointensity on T1 weighted images (T1WI) in 25 patients and slightly hyperintense in three. On T2 weighted images (T2WI), 17 lesions displayed homogeneous hypointense signal, and eight lesions possessed heterogeneous signals. The remaining three lesions featured slightly hyperintense signal on T2WI. Follow-up data were available in 23 of 30 benign cases treated with gross-total resection, and two patients experienced recurrence.
Spinal GCTTS should be suspected in cases with features such as the mass mainly involving the posterior bone elements, the lack of intralesional calcification, T2-weighted dark signals, and free of any cancer. Gross-total resection is an effective means for treating spinal GCTTS.
本研究旨在更全面地描述脊柱腱鞘巨细胞瘤（GCTTS），并进一步验证手术切除治疗该肿瘤的疗效。
回顾性分析2009年1月至2021年9月在我院诊断为脊柱GCTTS并接受手术切除的患者。总结临床资料和影像学图像，并分析随访时间超过12个月患者的临床结局。
纳入30例良性GCTTS患者和1例恶性GCTTS患者。30例良性病例中有28例可获得术前影像学图像。CT显示26例良性病变为以小关节为中心的软组织肿块伴溶骨性骨质破坏，2例为无骨质侵蚀的椎体前或肌内肿块。MRI显示25例患者在T1加权像（T1WI）上呈等信号或低信号，3例呈稍高信号。在T2加权像（T2WI）上，17个病灶呈均匀低信号，8个病灶信号不均匀。其余3个病灶在T2WI上呈稍高信号。30例接受全切除的良性病例中有23例有随访数据，2例患者复发。
对于主要累及后部骨结构、病灶内无钙化、T2加权像呈低信号且无任何癌症特征的病例，应怀疑为脊柱GCTTS。全切除是治疗脊柱GCTTS的有效方法。
