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VOLUME 66 , ISSUE 2 ( April-June, 2024 ) > List of Articles

CASE REPORT

Giant-cell Tumor of Dorsal Vertebra Presenting as a Posterior Mediastinal Mass: A Rare Case Report

Govindaraj Vishnukanth, Sivaselvi Chellamuthu, Mahesh B Vemuri, Nachiappa G Rajesh

Keywords : Case report, Dorsal vertebral lesion and denosumab, Giant cell tumor

Citation Information : Vishnukanth G, Chellamuthu S, Vemuri MB, Rajesh NG. Giant-cell Tumor of Dorsal Vertebra Presenting as a Posterior Mediastinal Mass: A Rare Case Report. Indian J Chest Dis Allied Sci 2024; 66 (2):64-67.

DOI: 10.5005/jp-journals-11007-0109

License: CC BY-NC 4.0

Published Online: 10-07-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Giant cell tumors (GCT) of bone also referred to as osteoclastoma or myeloid sarcoma are usually benign tumors but have the potential for local recurrence and metastasis. Giant cell tumors mostly involves the long bones with the proximal tibia and distal femur sites. Giant cell tumors of the spine presenting above the level of the sacrum is relatively less common. We report a patient with GCT arising from dorsal vertebrae and presenting as a huge mediastinal mass. A 25-year-old female presented with bilateral lower limb weakness, breathlessness, and difficulty in speaking. Chest X-ray showed bilateral upper lobe mass. On further evaluation with contrast-enhanced computed tomography (CECT) of the thorax a large well defined heterogeneously enhancing posterior mediastinal lesion with necrotic areas within and bony infiltration was noted. Sequential chest X-ray was suggestive of rapid progression within 15 days. Ultrasound-guided biopsy of mass lesion revealed features of giant cell tumor with immunohistochemical markers strongly positive for CD68, negative for S100, and β-HCG. The patient was subsequently started on denosumab given unresectable pulmonary metastasis.


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  1. Lee CG, Kim SH, Kim DM, et al. Giant cell tumor of upper thoracic spine. J Korean Neurosurg Soc 2014;55(3):167–169. DOI: 10.3340/jkns.2014.55.3.167.
  2. Patel S, Chiu RG, Rosinski CL, et al. Incidence, management, and outcomes of spinal giant cell tumor of bone in adult patients: A national cancer database analysis. World Neurosurg 2020;144: e296–e305. DOI: 10.1016/j.wneu.2020.08.135.
  3. Chakarun CJ, Forrester DM, Gottsegen CJ, et al. Giant cell tumor of bone: Review, mimics, and new developments in treatment. Radiographics 2013;33(1):197–211. DOI: 10.1148/rg.331125089.
  4. Donthineni R, Boriani L, Ofluoglu O, et al. Metastatic behaviour of giant cell tumour of the spine. Int Orthop 2009;33(2):497–501. DOI: 10.1007/s00264-008-0560-9.
  5. Viswanathan S, Jambhekar NA. Metastatic giant cell tumor of bone: Are there associated factors and best treatment modalities? Clin Orthop Relat Res 2010;468(3):827–833. DOI: 10.1007/s11999-009-0966-8.
  6. Kito M, Matusmoto S, Keisuke Ae, et al. Pulmonary metastasis from giant cell tumor of bone: Clinical outcome prior to the introduction of molecular target therapy. Japanese Journal of Clinical Oncology 2017;47(6):529–534. DOI: 10.1093/jjco/hyx033.
  7. Klenke FM, Wenger DE, Inwards CY, et al. Giant cell tumor of bone: Risk factors for recurrence. Clin Orthop Relat Res 2011;469(2):591–599. DOI: 10.1007/s11999-010-1501-7.
  8. Campanacci M, Baldini N, Boriani S, et al. Giant-cell tumor of bone. J Bone Joint Surg Am 1987;69(1):106–114. PMID: 3805057.
  9. Osaka S, Toriyama M, Taira K, et al. Analysis of giant cell tumor of bone with pulmonary metastases. Clin Orthop Relat Res 1997;(335): 253–261. PMID: 9020226.
  10. Boriani S, Bandiera S, Casadei R, et al. Giant cell tumor of the mobile spine: A review of 49 cases. Spine 2012;37(1):E37–E45. DOI: 10.1097/BRS.0b013e3182233ccd.
  11. Errani C, Tsukamoto S, Mavrogenis AF. How safe and effective is denosumab for bone giant cell tumour? Int Orthop 2017;41(11): 2397–2400. DOI: 10.1007/s00264-017-3536-9.
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