Giant cell tumors of the mobile spine with invasion of adjacent vertebrae: an unusual imaging finding

Gang Jiang,Zhi-Tao Yang,Qing-Lian Ji,Jing Pang,Ling-Ling Sun,Chuan-Ping Gao,Yong-Jun Ye

doi:10.1186/s12891-021-04610-0

Abstract

BackgroundGiant cell tumors of the mobile spine invasion of the adjacent vertebrae are an ignored imaging finding.MethodsNine patients with giant cell tumors of the mobile spine with invasion of the adjacent vertebrae confirmed by pathology were enrolled. Eight patients had pure giant cell tumors (GCTs), while one patient also had an aneurysmal bone cyst. All patients underwent conventional computed tomography, three-dimensional reconstruction, and conventional magnetic resonance imaging, while seven patients also underwent post-contrast magnetic resonance imaging.ResultsAll patients showed GCTs of the mobile spine that arose from the vertebral body and extended to the vertebral arch. The tumors showed soft-tissue attenuation with no evidence of a mineralized matrix. Pathological fracture was seen in five patients. The margin of the original tumor showed partial sclerosis in four patients and involved an adjacent vertebral body with a sclerotic rim in two patients. The tumors showed a homogeneous and similar signal intensity to the normal spinal cord on T1WI (T1-weighted image) in five patients. The cystic area of the tumors was hyperintense on T2WI in the remaining four patients, while one patient showed hemorrhage that was hyperintense on T1WI. The solid components of the GCTs show marked enhancement in all cases, while the cystic area of the tumors was observed without enhancement on contrast-enhanced images in four patients. Bone destruction of the adjacent vertebral body showed a homogeneous signal on T1WI and T2WI and marked enhancement on contrast-enhanced images.ConclusionsGiant cell tumors of the mobile spine with invasion into adjacent vertebrae are an unusual imaging finding. Radiologists should be familiar with this imaging characteristic.

Highlights

Giant cell tumors of the mobile spine invasion of the adjacent vertebrae are an ignored imaging finding
The left pedicle of the vertebral arch was involved in three patients (Fig. 1A); the right pedicle of the vertebral arch was involved in one patient (Fig. 2A); the right pedicle and lamina of the vertebral arch were invaded in three patients; the bilateral pedicle of the vertebral arch was invaded in one patient; and the bilateral pedicle, lamina, and spinous process of the vertebral arch were invaded in one patient (Fig. 3A)
Detection of adjacent vertebrae invasion was most sensitive in the sagittal plane on computed tomography (CT) and magnetic resonance imaging (MRI) images, especially when there was only minor bone destruction (Fig. 2B, and 3B)

Summary

Introduction

Giant cell tumors of the mobile spine invasion of the adjacent vertebrae are an ignored imaging finding. Giant cell tumors (GCTs) of the bone are relatively rare and account for 5% of all primary bone tumors [1]. They predominantly occur in the long bones near articulations after skeletal maturity, especially around the knee joint. GCTs of the mobile spine that involve adjacent vertebrae are extremely rare, with few reports in the literature [2, 3]. We report nine cases of GCTs of the mobile spine that invaded the adjacent vertebrae

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