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

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Gang Jiang ◽  
Ling-Ling Sun ◽  
Yong-Jun Ye ◽  
Zhi-Tao Yang ◽  
Qing-lian Ji ◽  
...  
Keyword(s):  
Giant Cell ◽  
Vertebral Body ◽  
Imaging Finding ◽  
Resonance Imaging ◽  
Giant Cell Tumors ◽  
Adjacent Vertebral Body ◽  
Contrast Enhanced ◽  
Mobile Spine ◽  
Marked Enhancement ◽  
Cystic Area

Abstract Background Giant cell tumors of the mobile spine invasion of the adjacent vertebrae are an ignored imaging finding. Methods Nine 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. Results All 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. Conclusions Giant cell tumors of the mobile spine with invasion into adjacent vertebrae are an unusual imaging finding. Radiologists should be familiar with this imaging characteristic.

scholarly journals Imaging Features of Aggressive Giant Cell Tumors of the Mobile Spine: Retrospective Analysis of 101 Patients From Single Center

2021 ◽  
pp. 219256822098228
Author(s):  
Bei Yuan ◽  
Lihua Zhang ◽  
Shaomin Yang ◽  
Hanqiang Ouyang ◽  
Songbo Han ◽  
...  
Keyword(s):  
Giant Cell ◽  
Vertebral Body ◽  
Signal Intensity ◽  
Imaging Features ◽  
Single Center ◽  
Giant Cell Tumors ◽  
Ct Guided ◽  
Cortical Destruction ◽  
Mobile Spine ◽  
T2 Weighted Images

Study Design: Retrospective study. Objectives: Giant cell tumors (GCTs) of the mobile spine can be locally aggressive. This study described and classified the typical and atypical appearance of aggressive spinal GCTs according to imaging findings to help the imaging diagnosis, especially for patients with rapid neurological deficit that may require emergent surgery without biopsy. Methods: Computed tomography (CT) and magnetic resonance imaging (MRI) scans of patients diagnosed with aggressive spinal GCTs at single center were reviewed. Results: Overall, 101 patients with 100 CT images and 94 MR images were examined. All lesions were osteolytic with cortical destruction; 95 lesions showed epidural extension; 90 were centered in the vertebral body; 82 showed pathological fracture and/or collapse of the vertebral body; 78 had pseudotrabeculation on CT; 80 showed low-to-iso signal intensity or heterogeneous high-signal intensity with cystic areas on the T2-weighted images; 9 showed fluid–fluid level on T2-weighted images; and 61 patients showed marked enhancement on contrast-enhanced CT and/or MRI. Forty-one lesions (40.6%) had at least 1 atypical radiographic feature: 19 involved ≥2 segments; 11 were centered in the posterior neural arch; 10 had a paravertebral mass over 2 segments; 16 showed partial margin sclerosis with partial cortical destruction on CT scans; and 3 showed mineralization within the tumor on CT. Eighty-eight patients underwent CT-guided biopsy with a diagnostic accuracy rate of 94.3%. Conclusions: Spinal GCTs might appear more radiologically atypical, and about 40% of the lesions may have at least 1 atypical feature. CT-guided biopsies are recommended for definitive diagnosis.

scholarly journals Magnetic resonance imaging compared to ultrasonography in giant cell arteritis: a cross-sectional study

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Ashley Yip ◽  
Elizabeth Torrey Jernberg ◽  
Mohammad Bardi ◽  
Julia Geiger ◽  
Frode Lohne ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Cross Sectional Study ◽  
Vascular Changes ◽  
Resonance Imaging ◽  
First Line ◽  
Cross Sectional ◽  
Contrast Enhanced ◽  
New Onset

Abstract Background There has been a shift in recent years to using ultrasound (US) and magnetic resonance imaging (MRI) as first-line investigations for suspected cranial large vessel vasculitis (LVV) and is a new recommendation by the EULAR 2018 guidelines for imaging in LVV. This cross-sectional study compares the performance of US and MRI and contrast-enhanced magnetic resonance angiography (MRA) for detecting vasculitis in patients with giant cell arteritis (GCA). Methods Patients with new-onset or already diagnosed GCA were recruited. The common temporal arteries and supra-aortic large vessels were evaluated by US and MRI/MRA. Blinded experts read the images and applied a dichotomous score (vasculitis: yes/no) in each vessel. Results Thirty-seven patients with giant cell arteritis (GCA) were recruited. Two patients were excluded. Of the remaining patients, nine had new-onset disease and 26 had established disease. Mean age was 71 years, and median C-reactive protein (CRP) was 7.5 mg/L. The median time between US and MRI was 1 day. Overall, US revealed vasculitic changes more frequently than MRI (p < 0.001). US detected vascular changes in 37% of vessels compared to 21% with MRI. Among patients with chronic disease, US detected vascular changes in 23% of vessels compared to 7% with MRI in (p < 0.001). The same was true for patients with new-onset disease. US detected vasculitic changes in 22% of vessels and MRI detected disease in 6% (p = 0.0004). Compared to contrast-enhanced MRA, US was more sensitive in detecting vasculitic changes in the large arteries, including the axillary, carotid, and subclavian arteries. Conclusion US more frequently detects vasculitic changes in the large arteries compared to contrast-enhanced MRA. When evaluating the cranial vessels, US performs similarly to MRI. This data supports the recommendation that US be considered as a first-line evaluation in patients suspected to have GCA.

scholarly journals Total Spondylectomy for Upper Thoracic Spine Giant Cell Tumor: A Case Report

2019 ◽  
Vol 12 (1) ◽  
pp. 131-138
Author(s):  
Eid Al-Shamary ◽  
Wafa Al-Dhafeeri ◽  
Abdulaziz Al-Sharydah ◽  
Sari Al-Suhibani ◽  
Haitham Kussaibi ◽  
...  
Keyword(s):  
Giant Cell ◽  
Thoracic Spine ◽  
Close Contact ◽  
En Bloc Resection ◽  
Giant Cell Tumors ◽  
En Bloc ◽  
Upper Thoracic Spine ◽  
Thoracic Spinal ◽  
Mobile Spine ◽  
Upper Thoracic

Introduction: Giant cell tumors (GCT) are benign lesions that are generally locally aggressive tumors with occasional malignant behavior. These tumors are most frequently encountered in long bones; however, they also occur rarely in the spine. GCT of the spine are rare pathological entities, and spinal involvement shows a sacral predilection, with only a few cases involving the supra-sacral segment (mobile spine). Only a few cases of thoracic spinal GCT are reported in the literature; these tumors are particularly uncommon in the thoracic segment. Presentation of Case: A 29-year-old man presented with a complaint of neck pain over the previous six months that radiated to his left hand. GCT of the upper thoracic spine was diagnosed, which was surgically managed using a 2-stage approach involving total resection of the tumor followed by spondylectomy and multilevel spinal fixation. Discussion: Accurate diagnosis of vertebral column lesions, and choosing an optimum management plan are crucial. In the majority of cases, En-bloc resection of GCTs is not feasible ought to the close contact of the lesion with the spinal cord. Larger studies are encouraged to ascertain the efficacy of variable management approaches, particularly compared with piecemeal resection techniques. Conclusion: Spinal GCT are a unique group of tumors with an uncommon and unexpected presentation. Although surgery is the mainstay of treatment for spinal GCT, the management of this tumor can be challenging. No clear management algorithm has been established, and the tumor displays an unpredictable course. Therefore, each case needs tailored treatment.

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