Iranian Journal of Neurosurgery
مجله جراحی مغز و اعصاب ایران
Iran J Neurosurg
Medical Sciences
http://irjns.org
1
admin
2423-6497
2423-6829
10.32598/irjns
en
jalali
1400
10
1
gregorian
2022
1
1
8
1
online
1
fulltext
en
Spinal Giant Cell Tumor in Neurospine Surgery: A Narrative Study
Neuroscience
Review
<div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><b> Background and Aim:</b> Spinal Giant Cell Tumor (GCT) is a primary low-grade malignant aggressive tumor of the spine and is more prevalent in the third and fourth decades of life.</span></span></span><br>
<span style="font-size:11pt"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif">Spinal GCT frequently occurs in the sacrum. The most common presentation of spinal GCT is pain. Spinal GCT is seldom observed as an asymptomatic, incidental radiological occurrence.</span></span></span><br>
<span style="font-size:11pt"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif">Based on the clinic-radiological findings, differential diagnoses of spinal GCT are Aneurismal Bone Cyst (ABC), plasmacytoma, symptomatic hemangioma, and Tuberculosis (TB). A biopsy is crucial for a definitive diagnosis. Because of the rich vascular supply about 24 hours prior to operation, Digital Subtraction Angiography (DSA) with tumor embolization is recommended. The treatment of choice for these tumors is complete, extralesional surgical resection which is not usually possible. General treatment is resorted as incomplete partial resection following local radiotherapy. The method of choice for reconstruction is cement or metallic cages and because of the high recurrence rate, bone graft is avoided. The local recurrence rate in the spinal column is lower than in other areas.</span></span></span><br>
<span style="font-size:11pt"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><b>Methods and Materials/Patients: </b>The spinal GCT incidence, manifestations, diagnosis, and management were concisely reviewed. Using the keywords of GCT, GCT manifestations, GCT complications, GCT management, and GCT incidence, all the relevant articles were retrieved from Google Scholar, Medline, and PubMed, reviewed critically, and analyzed.</span></span></span><br>
<span style="font-size:11pt"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><b>Results:</b> Spinal GCT rarely presents as an incidental finding in radiologic studies. Because of the high vascular supply of GCTs, preoperative embolization must be performed.</span></span></span><br>
<span style="font-size:11pt"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif">The ideal treatment of spinal GCT is complete surgical tumor excision and when not possible, intralesional resection is an alternative treatment. The prognosis of spinal GCT is not good as other primary spinal tumors because of incomplete excision of the tumor and following high recurrence rate.</span></span></span><br>
<span style="font-size:11pt"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><b>Conclusion:</b> Spinal GCTs are complex clinical entities. Operation is obligatory, and postoperative close follow-up is mandatory to stop recurrences early</span></span></span></div>
GCT, Spinal GCT, GCT management, GCT complications, GCT manifestations
0
0
http://irjns.org/browse.php?a_code=A-10-400-4&slc_lang=en&sid=1
Seyed Reza
Mousavi
moosavi_r@sums.ac.ir
10031947532846007823
10031947532846007823
Yes
Shiraz Neuroscience Research Center, Department of Neurosurgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Navid
Kalani
navidkalani@ymail.com
10031947532846007824
10031947532846007824
No
Department of Anesthesiology, Critical Care and Pain Management Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
Ali
Kazeminezhad
kazemimd@msn.com
10031947532846007825
10031947532846007825
No
Department of Neurosurgery, Peymanieh Hospital, Jahrom University of Medical Sciences, Jahrom, Iran