Verhagen W I, Bartels R H, Schaafsma H E, Rob de Jong T H
Department of Neurology, Canisius Wilhelmina Hospital Nijmegen, The Netherlands.
Spine (Phila Pa 1976). 1998 Jul 15;23(14):1609-11. doi: 10.1097/00007632-199807150-00020.
A case report.
Giant cell tumors are rare primary bone tumors. Generally, these tumors are expanding osteolytic lesions, but soft tissue giant cell tumors can occur. This is a case report of an unusual incidence of a giant cell tumor within the spinal sacral canal, in which there was no involvement of the surrounding bone or ligament structures and that was signaled by radicular pain. The pathologic course of the tumor is described.
A 24-year-old woman had monoradicular pain in the right leg in the region of S2. Neuroradiologic examination showed a mass within the sacral spinal canal compromising the right S2 root, with no sign of bone involvement.
A sacral laminectomy was performed. A tumor was located entirely intraspinally and extradurally and was removed completely. A giant cell tumor was identified in histologic examination.
The patient recovered completely. No local regrowth or metastasis occurred during a 20-month follow-up.
The treatment of choice in giant cell tumors is complete surgical resection. Radiotherapy is recommended in cases of subtotal resection. Careful follow-up is warranted, because recurrence and metastasis are not uncommon.
病例报告。
骨巨细胞瘤是一种罕见的原发性骨肿瘤。一般来说，这些肿瘤是膨胀性溶骨性病变，但也可发生软组织骨巨细胞瘤。本文报告一例骶管内骨巨细胞瘤的罕见病例，该肿瘤未累及周围骨质或韧带结构，以神经根性疼痛为首发症状，并描述了肿瘤的病理过程。
一名24岁女性，在S2区域出现右下肢单神经根性疼痛。神经放射学检查显示骶管内有一肿块压迫右侧S2神经根，无骨质受累迹象。
行骶椎板切除术。肿瘤完全位于椎管内硬膜外，被完整切除。组织学检查确诊为骨巨细胞瘤。
患者完全康复。在20个月的随访中未出现局部复发或转移。
骨巨细胞瘤的首选治疗方法是手术完整切除。次全切除病例建议行放疗。鉴于复发和转移并不罕见，故需密切随访。
