Giant cell tumor

What is it?

A giant cell tumor (GCT) of bone is a benign tumor that typically occurs near the joints of the knee, wrist, shoulder, or spine. The spine is composed of bones called vertebrae. Giant cell tumors can develop at any spinal level – the cervical spine, thoracic spine, lumbar spine, or the sacrum. They are more common in women than in men, and mostly occur in the third and fourth decade of life.

Symptoms

One common symptom of a spinal giant cell tumor is pain at the tumor site. Other symptoms occurs if the tumor compresses the spinal cord or nerves. If in the sacrum, tumor may cause bowel or bladder incontinence, leg weakness, or sexual dysfunction. At the other spinal levels, symptoms vary depending on the tumor’s location and size. They may include arm weakness, numbness, tingling, or bowel or bladder dysfunction. Rarely, a tumor can weaken a vertebra to such an extent that the vertebra breaks after a relatively minor trauma.

Diagnosis

Giant cell tumors can be identified on several types of imaging scans: X-ray, Magnetic resonance (MR) imaging scan, Computed tomography (CT) scan. A CT-guided needle biopsy may help confirm the diagnosis.

Treatment

Complete surgical removal gives the best chance of avoiding recurrence, and is the treatment of choice for giant cell tumors whenever possible. Depending on the tumor location, surgical options include:

  • Anterior cervical corpectomy
  • Cervical laminectomy
  • Thoracic corpectomy
  • Thoracic laminectomy
  • Lumbar laminectomy
  • Lumbar corpectomy
  • Microsurgical tumor removal

Spinal fusion and stabilization with metallic implants are often performed following complete tumor removal.