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28岁女性的L5骨巨细胞瘤。

L5 giant cell tumor in 28-year-old female.

作者信息

Baskoro Wisnu, Pratama Muhammad Fakhri Raiyan, Fauziah Early Isnaeni Nur, Rusidi Hanan Anwar, Kameswari Bidari

机构信息

Department of Neurosurgery, Dr. Soeradji Tirtonegoro Central Public Hospital, Klaten, Indonesia.

Faculty of Medicine, Gadjah Mada University, Sleman, Indonesia.

出版信息

Surg Neurol Int. 2024 Nov 29;15:436. doi: 10.25259/SNI_533_2024. eCollection 2024.

Abstract

BACKGROUND

Giant cell tumor of bone (GCTB) is a rare benign tumor that may also exhibit aggressive local behavior. Recurrence of GCTB is common even after complete resection. GCTB typically occurs in long bones, and only 2.7% are found in the spine. Here, a 28-year-old female with a magnetic resonance (MR)-documented L5 lumbar spine GCTB presented with a cauda equina syndrome effectively managed with a decompressive laminectomy/L4-S1 fusion.

CASE DESCRIPTION

A 28-year-old female presented with a 1-year history of lower extremity pain/paresthesia that had exacerbated over the previous 1 month. When the MR imaging revealed cauda equina compression due to a L5 hypodense lesion, the patient successfully underwent a decompressive laminectomy/L4-S1 fusion. The histopathology examination confirmed the presence of a GCTB.

CONCLUSION

While gross total excision for GCTB is the treatment of choice, for those undergoing only subtotal/partial resections, additional adjuvant therapy may be warranted. Notably, even despite extensive resections, these lesions have a high rate of recurrence.

摘要

背景

骨巨细胞瘤(GCTB)是一种罕见的良性肿瘤,但也可能表现出侵袭性的局部行为。即使在完全切除后,GCTB复发也很常见。GCTB通常发生在长骨中,仅2.7%发生在脊柱。在此,一名28岁女性经磁共振(MR)证实患有L5腰椎GCTB,表现为马尾神经综合征,通过减压椎板切除术/L4-S1融合术得到有效治疗。

病例描述

一名28岁女性有1年的下肢疼痛/感觉异常病史,在过去1个月内加重。当MR成像显示由于L5低密度病变导致马尾神经受压时,患者成功接受了减压椎板切除术/L4-S1融合术。组织病理学检查证实为GCTB。

结论

虽然GCTB的根治性切除是首选治疗方法,但对于那些仅接受次全/部分切除的患者,可能需要额外的辅助治疗。值得注意的是,即使进行了广泛切除,这些病变的复发率仍然很高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd60/11618681/b67f0d0fbcc1/SNI-15-436-g001.jpg

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