Thoracic giant cell tumor after two total en bloc spondylectomies including one emergency surgery:A case report  

作　　者：Hai-Feng Liang Hao Xu Meng-Na Zhan Jian Xiao Juan Li Qin-Ming Fei 

机构地区：[1]Department of Orthopaedic Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China [2]Department of Orthopaedic Surgery,Shanghai Geriatric Medical Center,Shanghai 201104,China [3]Department of Pathology,Zhongshan Hospital,Fudan University,Shanghai 200032,China [4]Department of Orthopaedic Surgery,Zhongshan Hospital Wusong Branch,Fudan University,Shanghai 200940,China

出　　处：《World Journal of Clinical Cases》2024年第16期2894-2903,共10页世界临床病例杂志

基　　金：Supported by The Shanghai Municipal Health Commission Clinical Research Project,No.202140140.

摘　　要：BACKGROUND For patients with acute paraplegia caused by spinal giant cell tumor(GCT)who require emergency decompressive surgery,there is still a lack of relevant reports on surgical options.This study is the first to present the case of an acute paraplegic patient with a thoracic spinal GCT who underwent an emergency total en bloc spondylectomy(TES).Despite tumor recurrence,three-level TES was repeated after denosumab therapy.CASE SUMMARY A 27-year-old female patient who underwent single-level TES in an emergency presented with sudden severe back pain and acute paraplegia due to a thoracic spinal tumor.After emergency TES,the patient's spinal cord function recovered,and permanent paralysis was avoided.The postoperative histopathological examination revealed that the excised neoplasm was a rare GCT.Unfortunately,the tumor recurred 9 months after the first surgery.After 12 months of denosumab therapy,the tumor size was reduced,and tumor calcification.To prevent recurrent tumor progression and provide a possible cure,a three-level TES was performed again.The patient returned to an active lifestyle 1 month after the second surgery,and no recurrence of GCT was found at the last follow-up.CONCLUSION This patient with acute paraplegia underwent TES twice,including once in an emergency,and achieved good therapeutic results.TES in emergency surgery is feasible and safe when conditions permit;however,it may increase the risk of tumor recurrence.

关 键 词：Giant cell tumor Thoracic spine Emergency treatment Total en bloc spondylectomy Denosumab therapy Case report 

分 类 号：R738.1[医药卫生—肿瘤]