Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2021; 9(14): 3394-3402
Published online May 16, 2021. doi: 10.12998/wjcc.v9.i14.3394
Tenosynovial giant cell tumor involving the cervical spine: A case report
Jing-Hui Zhu, Miao Li, Yan Liang, Jian-Huang Wu
Jing-Hui Zhu, Miao Li, Yan Liang, Jian-Huang Wu, Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
Author contributions: Zhu JH reviewed the literature and drafted the manuscript; Li M analyzed and interpreted the imaging findings; Liang Y contributed to manuscript drafting; Wu JH was responsible for the revision of the manuscript for important intellectual content; all authors have read and approved the final manuscript.
Supported by The National Natural Science Foundation of China (General Program), No. 81472073; and the Natural Science Foundation of Hunan Province of China, No. 2019JJ40518.
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 conflict of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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:
Corresponding author: Jian-Huang Wu, PhD, Chief Physician, Department of Spine Surgery, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha 410008, Hunan Province, China.
Received: December 30, 2020
Peer-review started: December 30, 2020
First decision: February 12, 2021
Revised: February 21, 2021
Accepted: March 3, 2021
Article in press: March 3, 2021
Published online: May 16, 2021

Tenosynovial giant cell tumors (TGCTs) are a frequent benign proliferative disease originating from the synovial membrane. However, TGCTs rarely occur in the spine. The purpose of this paper is to report a case of TGCT occurring in the cervical spine. Although the disease is rare, it is essential to consider the possibility of TGCT in axial skeletal lesions. Awareness of spinal TGCTs is important because their characteristics are similar to common spinal tumor lesions.


A 49-year-old man with a 2-year history of neck pain and weakness in both lower extremities was referred to our ward. Imaging revealed a mass extending from the left epidural space to the C4-5 paravertebral muscles with uneven enhancement. The tumor originated in the synovium of the C4-5 lesser joint and eroded mainly the C4-5 vertebral arch and spine. Puncture biopsy was suggestive of a giant cell-rich lesion. The patient had pulmonary tuberculosis, and we first administered anti-tuberculosis treatment. After the preoperative requirements of the anti-tuberculosis treatment were met, we used a posterior cervical approach to completely remove the mass after fixation with eight pedicle screws. The mass was identified as a TGCT by postoperative immunohistochemical analysis. Recurrence was not detected after 1 year of follow-up.


Spinal TGCTs are often misdiagnosed. The radiological changes are not specific. The ideal treatment comprises complete excision with proper internal fixation, which can significantly reduce postoperative recurrence.

Keywords: Tenosynovial giant cell tumors, Cervical vertebrae, Spinal diseases, Tumor, Spine, Case report

Core Tip: This paper reviews a rare case of a tenosynovial giant cell tumor (TGCT) growing in the spine, eroding the C4-5 vertebral arches and the spinous processes, the radiological features of which mimic those of other neoplastic lesions. The definitive diagnosis of TGCT is made by immunohistochemistry. The ideal treatment comprised complete resection of the mass and appropriate internal fixation. By reviewing the diagnostic and therapeutic history and analyzing the clinical and radiological manifestations, a better understanding of the characteristics of TGCTs of the spine can be achieved, helping to improve their diagnosis and treatment.