Giant Cell Tumor of the L1 Vertebra with a Large Soft Tissue Component: A Case Report

Abstract

Giant cell tumor (GCT) is a locally aggressive benign tumor that most often appears on long bones. Less than 10% of GCT’s in the spine are occur above the sacrum, and cases involving the lumbar spine are relatively little reported in the literature. Soft tissue invasion of GCT is rare. We present a case of GCT in the L1 vertebra, a large soft tissue component, that occurred in a 24-year-old female patient with low back pain and right radiculopathic thigh pain for approximately 3 months. The patient had no neurological deficit. A lytic lesion involving the L1 vertebral body, more prominently in the right half, extending to the pedicle and transverse process on the right was detected in computed tomography (CT) and magnetic resonance imaging (MRI) sections. In the MR imaging taken 2 months later; It was noted that the mass increased in size and the soft tissue content extending to the right psoas muscle developed. Tru-cut biopsy was performed for the diagnosis and the pathology diagnosis was evaluated as consistent with GCT. The patient underwent L1 vertebral spondylectomy and T1–L3 instrumentation with pedicle screw/mesh cage. Denosumab treatment was started after surgery. The histopathology results of the excised bone and soft tissues were also evaluated as consistent with GCT. As a result, GCT should be considered in the differential diagnosis of destructive lesions with a soft tissue component in the lumbar vertebra.Key words: giant cell tumor, lumbar spine, soft tissue component, clinical case.Corresponding author: Alim Can Baymurat, Assistant Professor of the Department of Orthopedics and Traumatology, Gazi University Faculty of Medicine, Ankara, Turkey Postal code: 06560Address: Turkey, Ankara, Polis Mah, Gazi University Rectorate, Bandırma Cad. No:6/1, YenimahallePhone: +903122022000Email: alimcanbaymurat@yahoo.com Gani.box.94@gmail.comJ Trauma Ortho Kaz 2023; 3 (69): 19-24Recieved: 18-05-2023Accepted: 04-06-2023 This work is licensed under a Creative Commons Attribution 4.0 International License