Caldero Carrete Jordina, Tabanez Joana, Civello Alexander, Rusbridge Clare
Fitzpatrick Referrals Orthopaedics and Neurology, Eashing, UK.
SYNLAB's Veterinary Pathology Group (VPG), Exeter, UK.
JFMS Open Rep. 2023 Apr 11;9(1):20551169231160227. doi: 10.1177/20551169231160227. eCollection 2023 Jan-Jun.
A 10-year-old male neutered domestic shorthair cat was presented with a 5-month history of progressive non-ambulatory paraparesis. Initial vertebral column radiographs revealed an L2-L3 expansile osteolytic lesion. Spinal MRI showed a well-demarcated, compressive expansile extradural mass lesion affecting the caudal lamina, caudal articular processes and right pedicle of the second lumbar vertebra. The mass was hypointense/isointense on T2-weighted images, isointense on T1-weighted images and had mild homogeneous contrast enhancement after gadolinium administration. MRI of the remaining neuroaxis and CT of the neck, thorax and abdomen with ioversol contrast revealed no additional neoplastic foci. The lesion was removed by en bloc resection via a dorsal L2-L3 laminectomy, including the articular process joints and pedicles. Vertebral stabilisation was performed with titanium screws placed within L1, L2, L3 and L4 pedicles with polymethylmethacrylate cement embedding. Histopathology revealed an osteoproductive neoplasm composed of spindle and multinucleated giant cells without detectable cellular atypia or mitotic activity. On immunohistochemical evaluation, osterix, ionised calcium-binding adaptor molecule 1 and vimentin labelling were observed. Based on the clinical and histological features, a giant cell tumour of bone was considered most likely. Follow-up at 3 and 24 weeks postoperatively demonstrated significant neurological improvement. Postoperative full-body CT at 6 months showed instability of the stabilisation construct but absence of local recurrence or metastasis.
This is the first reported case of a giant cell tumour of bone in the vertebra of a cat. We present the imaging findings, surgical treatment, histopathology, immunohistochemistry and outcome of this rare neoplasm.
一只10岁已绝育的雄性家养短毛猫因进行性非行走性双下肢轻瘫5个月前来就诊。最初的脊柱X线片显示L2-L3椎体有膨胀性溶骨性病变。脊柱MRI显示一个边界清晰、压迫性膨胀性硬膜外肿块病变,累及第二腰椎的尾侧椎板、尾侧关节突和右侧椎弓根。该肿块在T2加权图像上呈低信号/等信号,在T1加权图像上呈等信号,钆剂注射后有轻度均匀强化。其余神经轴的MRI以及颈部、胸部和腹部经碘海醇对比剂增强的CT检查均未发现其他肿瘤病灶。通过L2-L3椎体后路全椎板切除术整块切除病变,包括关节突关节和椎弓根。使用钛螺钉置入L1、L2、L3和L4椎弓根,并注入聚甲基丙烯酸甲酯骨水泥进行椎体稳定术。组织病理学显示为一种由梭形细胞和多核巨细胞组成的骨生成性肿瘤,未检测到细胞异型性或有丝分裂活性。免疫组化评估显示有osterix、离子钙结合衔接分子1和波形蛋白标记。根据临床和组织学特征,最有可能为骨巨细胞瘤。术后3周和24周的随访显示神经功能有显著改善。术后6个月的全身CT显示稳定结构不稳定,但无局部复发或转移。
这是首例报道的猫椎体骨巨细胞瘤病例。我们展示了这种罕见肿瘤的影像学表现、手术治疗、组织病理学、免疫组化及预后情况。