Unusual presentation of giant cell tumor originating from a facet joint of the thoracic spine in a child: a case report and review of the literature

Journal of Medical Case Reports

Anupong Nitiruangjaras²  Boonsin Tangtrakulwanich¹  Koopong Siribumrungwong¹ 

[1] Department of Orthopedic Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkla 90110, Thailand;Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkla 90110, Thailand

关键词: Synovium;    Spine;    Giant cell tumor;   

Others  :  1181141
DOI  :  10.1186/1752-1947-7-178

 received in 2013-03-19, accepted in 2013-05-24,  发布年份 2013

【 摘 要 】

Introduction

Giant cell tumor of the synovium is a common benign lesion that frequently occurs at the tendon sheaths in the hand; it is usually found in adults over 30 years old. It is related to pigmented villonodular synovitis. Giant cell tumor of the synovium or pigmented villonodular synovitis has been described rarely in the axial skeleton especially in the thoracic vertebrae of a child.

Case presentation

A previously healthy 7-year-old Thai girl presented with back pain and progressive paraparesis and was unable to walk for 1 month. She had weakness and hyperreflexia of both lower extremities. Magnetic resonance imaging showed a well-defined homogeneously and intensely enhanced extradural mass with cord compression at T4 to T7 levels. The patient underwent laminectomy at T4 through to T7 and total tumor removal. Permanent histopathologic sections and immunostains revealed a giant cell tumor of the synovium. Postoperative neurological status recovered to grade V. Magnetic resonance imaging at the 1-year follow-up showed no recurrence and there was no clinical recurrence at the 2-year follow-up.

Conclusion

We report an extremely rare case of giant cell tumor in the epidural space that extended from a thoracic facet joint. The tumor was removed successfully through laminectomies. Although giant cell tumor of a facet joint of the thoracic spine is very rare, it must be considered in the differential diagnosis for masses occurring in the epidural space in a child. Total tumor removal is the best treatment. Careful monitoring of recurrence can achieve a good clinical outcome.

【 授权许可】

   
2013 Siribumrungwong et al.; licensee BioMed Central Ltd.

【 图 表 】

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