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Giant Cell Tumor of a Lumbar Vertebra in a 7-Year-Old Child: A Case Report

Metkar, Umesh MD*; Wardak, Zabi MD; Katz, Danielle A. MD*; Lavelle, William F. MD*

Journal of Pediatric Orthopaedics:
doi: 10.1097/BPO.0b013e31826193e7
Tumors
Abstract

Study Design: This case provides a rare occurrence of a giant cell tumor (GCT) in posterior elements of a lumbar vertebra in a 7-year-old child with successful outcome after surgical excision and regular follow-ups.

Objective: To present a unique case report of a pediatric GCT in the vertebral column and results.

Summary of Background Data: GCT is a rare bone tumor seen in 3% to 5% of primary bone neoplasm. Approximately 7% of GCTs are found in the vertebral column. GCT of the spine is found in only 5% to 7% of cases and can occur in any region of the spine but are believed to be predominantly in the sacrum. Despite its benign nature, expansion in a confined space makes early detection of spinal GCTs important to prevent occurrence of compressive myelopathy/radiculopathy. The presence of a GCT in a child younger than 10 years of age, in posterior elements of a lumbar vertebral body, has not been reported earlier.

Methods: On the basis of the clinical history, radiograph of the thoracolumbar spine, computed tomography of lumbar spine, and magnetic resonance imaging, a preliminary diagnosis of osteoblastoma was made.

Results: The patient presented with a lytic lesion with involvement of posterior elements, 1 side the pedicle extending into the body of a lumbar vertebra (L3) and had extension into the paraspinal muscles. Intraoperative exploration and frozen section showed the presence of a typical histologic picture of a GCT. Ipsilateral pedicle, posterior elements, and the superior articular facet were excised. En bloc resection was found not to be feasible due to the friable nature of the tumor and involvement of the soft tissues. In addition, fusion was avoided with consideration of the young age of the patient.

Conclusions: The patient has been free of any recurrence as of his last follow-up visit.

Author Information

*Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY

Department of General Surgery, Loma Linda University Medical Center, Loma Linda, CA

None of the authors received financial support for this study.

The authors declare no conflict of interest.

Reprints: William F. Lavelle, MD, Department of Orthopedic Surgery, Upstate Orthopedics, SUNY Upstate Medical University, 6620 Fly Road, Suite 200, East Syracuse, NY 13057. E-mail: lavellew@upstate.edu.

© 2012 Lippincott Williams & Wilkins, Inc.