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胸椎骨巨细胞瘤:脊髓压迫的罕见病因。

Giant cell tumor of the thoracic spine: An unusual cause for spinal cord compression.

作者信息

Gader Ghassen, Attig Fatma Ben, Mansour Wiem, Slimane Abdelhafidh, Bourgou Malek, Badri Mohamed, Zammel Ihsèn

机构信息

Department of Neurosurgery, Trauma and Burns Center, Ben Arous. University of Tunis - El Manar, Faculty of Medicine of Tunis, Tunisia.

Department of Neurosurgery, National Institute of Neurology, Tunis. University of Tunis - El Manar, Faculty of Medicine of Tunis, Tunisia.

出版信息

Radiol Case Rep. 2025 Apr 19;20(7):3372-3375. doi: 10.1016/j.radcr.2025.03.055. eCollection 2025 Jul.

Abstract

Giant cell tumors (GCTs) of bone are uncommon neoplasms, typically located in the metaphysis of long bones, with rare occurrences in the spine, especially in the thoracic region. We report the case of a 34-year-old woman with a history of psoriasis and celiac disease, who presented with progressive inflammatory back pain and paraparesis. Imaging revealed an osteolytic mass at the T11 vertebra, causing dorsal spinal cord compression. Emergency surgery was performed, with histopathology confirming GCT. Despite initial recovery of motor function, surgical stabilization was later necessary to prevent spinal instability. The patient was started on adjuvant Denosumab therapy and remained asymptomatic on follow-up. This case highlights the rarity of GCT in the thoracic spine and associated diagnostic and therapeutic challenges. Though benign, GCTs can cause severe spinal cord compression, necessitating prompt surgical intervention to preserve neurological function. Denosumab therapy shows promise in controlling tumor progression and enhancing surgical outcomes. Multidisciplinary management and regular follow-up are essential to prevent recurrence and improve prognosis.

摘要

骨巨细胞瘤(GCT)是一种罕见的肿瘤,通常位于长骨的干骺端,在脊柱中罕见,尤其是在胸椎区域。我们报告了一例34岁患有银屑病和乳糜泻病史的女性,她出现进行性炎性背痛和双下肢轻瘫。影像学检查显示T11椎体有一个溶骨性肿块,导致脊髓受压。进行了急诊手术,组织病理学证实为GCT。尽管最初运动功能有所恢复,但后来仍需要进行手术固定以防止脊柱不稳定。患者开始接受地诺单抗辅助治疗,随访期间无症状。该病例突出了胸椎GCT的罕见性以及相关的诊断和治疗挑战。尽管GCT是良性的,但可导致严重的脊髓压迫,需要及时进行手术干预以保留神经功能。地诺单抗治疗在控制肿瘤进展和改善手术效果方面显示出前景。多学科管理和定期随访对于预防复发和改善预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77b8/12032865/b9b33f30a90e/gr1.jpg

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