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颈椎骨巨细胞瘤:一例报告。

Giant cell tumor of the cervical spine: A case report.

作者信息

Alolayan Omar Abdulaziz, Korkoman Abdulrahman Jalwi, Alnasser Abdullah Adel

机构信息

Orthopedic Surgery Department at Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Orthopedic Surgery Department at the University of Bisha, Bisha, Saudi Arabia.

出版信息

Int J Surg Case Rep. 2025 Jan;126:110676. doi: 10.1016/j.ijscr.2024.110676. Epub 2024 Nov 29.

Abstract

INTRODUCTION

A Giant Cell Tumor (GCT) of the bone is a locally osteolytic tumor made up of mononuclear ovoid stromal cells and multinucleated giant cells. It commonly affects long bones like the distal femur and proximal tibia, but can also develop in the cervical spine during the third and fourth decades of life.

PRESENTATION OF CASE

A 20-year-old female presented to the clinic with a complaint of neck pain persisting for one month. Clinical examination revealed bilateral radiculopathy in the upper limb, which was also associated with pain in the left shoulder and elbow. Imaging revealed a destructive lesion in the 7th cervical vertebra (C7). A biopsy was done which indicated a giant cell tumor (GCT). A C7 corpectomy was performed, which included the removal of the C7 vertebral body and application of a cage. At the two-year follow-up, the patient remained asymptomatic, and radiographs showed no signs of recurrence.

DISCUSSION

A Giant Cell Tumor (GCT) occurring above the sacrum, especially in the cervical spine, is extremely rare. Symptoms of GCT are often nonspecific and can include neck pain, numbness, and weakness in the upper limbs, which are sometimes mistaken for myalgia or disc disease. The main treatment goal for GCT is "en bloc" resection while preserving the joint, though this can be challenging, particularly in spinal cases.

CONCLUSION

It is crucial to acknowledge that GCT can appear in uncommon sites and age groups. Surgeons must have a high level of awareness and perform an adequate preoperative workup, before definitive treatment. The patient should undergo regular follow-ups to detect any recurrence or metastasis at an early stage.

摘要

引言

骨巨细胞瘤(GCT)是一种局部溶骨性肿瘤,由单核卵圆形基质细胞和多核巨细胞组成。它通常影响长骨,如股骨远端和胫骨近端,但也可在生命的第三和第四个十年期间发生于颈椎。

病例介绍

一名20岁女性因颈部疼痛持续一个月就诊。临床检查发现上肢双侧神经根病,同时伴有左肩和肘部疼痛。影像学检查显示第7颈椎(C7)有一个破坏性病变。进行了活检,结果显示为骨巨细胞瘤(GCT)。实施了C7椎体次全切除术,包括切除C7椎体并植入椎间融合器。在两年的随访中,患者无症状,X线片显示无复发迹象。

讨论

骶骨以上发生的骨巨细胞瘤(GCT),尤其是在颈椎,极为罕见。骨巨细胞瘤的症状通常不具有特异性,可包括颈部疼痛、上肢麻木和无力,有时会被误诊为肌痛或椎间盘疾病。骨巨细胞瘤的主要治疗目标是在保留关节的同时进行“整块”切除,尽管这可能具有挑战性,特别是在脊柱病例中。

结论

必须认识到骨巨细胞瘤可出现在不常见的部位和年龄组。外科医生在进行确定性治疗之前必须有高度的认识并进行充分的术前检查。患者应定期随访,以便早期发现任何复发或转移。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89d4/11652928/e61f55ec9838/gr1.jpg

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