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Yuan B, Zhang L, Yang S, Ouyang H, Han S, Jiang L, Wei F, Yuan H, Liu X, Liu Z. Imaging Features of Aggressive Giant Cell Tumors of the Mobile Spine: Retrospective Analysis of 101 Patients From Single Center. Global Spine J 2022; 12:1449-1461. [PMID: 33499650 PMCID: PMC9393967 DOI: 10.1177/2192568220982280] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
STUDY DESIGN Retrospective study. OBJECTIVES Giant cell tumors (GCTs) of the mobile spine can be locally aggressive. This study described and classified the typical and atypical appearance of aggressive spinal GCTs according to imaging findings to help the imaging diagnosis, especially for patients with rapid neurological deficit that may require emergent surgery without biopsy. METHODS Computed tomography (CT) and magnetic resonance imaging (MRI) scans of patients diagnosed with aggressive spinal GCTs at single center were reviewed. RESULTS Overall, 101 patients with 100 CT images and 94 MR images were examined. All lesions were osteolytic with cortical destruction; 95 lesions showed epidural extension; 90 were centered in the vertebral body; 82 showed pathological fracture and/or collapse of the vertebral body; 78 had pseudotrabeculation on CT; 80 showed low-to-iso signal intensity or heterogeneous high-signal intensity with cystic areas on the T2-weighted images; 9 showed fluid-fluid level on T2-weighted images; and 61 patients showed marked enhancement on contrast-enhanced CT and/or MRI. Forty-one lesions (40.6%) had at least 1 atypical radiographic feature: 19 involved ≥2 segments; 11 were centered in the posterior neural arch; 10 had a paravertebral mass over 2 segments; 16 showed partial margin sclerosis with partial cortical destruction on CT scans; and 3 showed mineralization within the tumor on CT. Eighty-eight patients underwent CT-guided biopsy with a diagnostic accuracy rate of 94.3%. CONCLUSIONS Spinal GCTs might appear more radiologically atypical, and about 40% of the lesions may have at least 1 atypical feature. CT-guided biopsies are recommended for definitive diagnosis.
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Affiliation(s)
- Bei Yuan
- Orthopaedic Department, Peking University Third Hospital, Haidian District, Beijing, China,Peking University Health Science Center, Haidian District, Beijing, China
| | - Lihua Zhang
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, China
| | - Shaomin Yang
- Department of Pathology, Peking University Third Hospital, Haidian District, Beijing, China
| | - Hanqiang Ouyang
- Orthopaedic Department, Peking University Third Hospital, Haidian District, Beijing, China
| | - Songbo Han
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, China
| | - Liang Jiang
- Orthopaedic Department, Peking University Third Hospital, Haidian District, Beijing, China,Liang Jiang and Zhongjun Liu, Orthopaedic Department, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing 100191, China. Emails: ;
| | - Feng Wei
- Orthopaedic Department, Peking University Third Hospital, Haidian District, Beijing, China
| | - Huishu Yuan
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, China
| | - Xiaoguang Liu
- Orthopaedic Department, Peking University Third Hospital, Haidian District, Beijing, China
| | - Zhongjun Liu
- Orthopaedic Department, Peking University Third Hospital, Haidian District, Beijing, China,Liang Jiang and Zhongjun Liu, Orthopaedic Department, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing 100191, China. Emails: ;
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Agarwal S, Chawla S, Agarwal S, Agarwal P. Giant cell tumour 2nd metatarsal-Result with en-bloc excision and autologous fibular grafting. Foot (Edinb) 2015; 25:265-9. [PMID: 26441038 DOI: 10.1016/j.foot.2015.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 02/01/2015] [Accepted: 07/25/2015] [Indexed: 02/04/2023]
Abstract
Giant cell tumour (GCT) of the small bones is relatively uncommon tumour. It occurs most commonly in the distal portions of femur and radius and proximal end of tibia. GCT of small bones presents at advanced stages with major bony destruction. These tumours represent more aggressive course; associated with increased local recurrence rates (40%) and metastasis. Various treatment modalities like en-bloc resection, cryosurgery, intralesional curettage with burring/phenolization or bone cement are available. In our case en-bloc resection with reconstruction using nonvascular autogenous fibular strut graft was used in patient of 2nd metatarsal GCT and a favourable functional outcome was observed.
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Affiliation(s)
| | - Sumit Chawla
- Maharani Laxmi Bai Medical College, Jhansi, UP, India
| | - Sippy Agarwal
- Maharani Laxmi Bai Medical College, Jhansi, UP, India
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