Liang HF, Xu H, Zhan MN, Xiao J, Li J, Fei QM. Thoracic giant cell tumor after two total en bloc spondylectomies including one emergency surgery: A case report. World J Clin Cases 2024; 12(16): 2894-2903 [PMID: 38899300 DOI: 10.12998/wjcc.v12.i16.2894]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hai-Feng Liang, Hao Xu, Jian Xiao, Juan Li, Qin-Ming Fei, Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Hai-Feng Liang, Juan Li, Department of Orthopaedic Surgery, Shanghai Geriatric Medical Center, Shanghai 201104, China
Meng-Na Zhan, Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Qin-Ming Fei, Department of Orthopaedic Surgery, Zhongshan Hospital Wusong Branch, Fudan University, Shanghai 200940, China
Co-first authors: Hai-Feng Liang and Hao Xu.
Co-corresponding authors: Juan Li and Qin-Ming Fei.
Author contributions: Liang HF and Xu H contributed equally to this work as co-first authors; Li J and Fei QM contributed equally to the manuscript; Liang HF, Xu H and Zhan MN contributed to study design, data collection and analysis; Li J and Fei QM contributed to conceptualization; Liang HF contributed to original manuscript writing; Fei QM, Li J and Xiao J contributed to language check, review and editing. All authors commented on previous versions of the manuscript, read and approved the final manuscript.
Supported byThe Shanghai Municipal Health Commission Clinical Research Project, No. 202140140.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors read the CARE Checklist (2016), and this manuscript was prepared and revised according to its guidelines.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: February 7, 2024 Revised: March 15, 2024 Accepted: April 17, 2024 Published online: June 6, 2024 Processing time: 112 Days and 0.5 Hours
Abstract
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.
Core Tip: 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. 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.
