The Spine Journal 15 (2015) 1684–1685
Extremely large giant-cell tumor of sacrum with successful resection via posterior approach A 17-year-old woman presented with a 1-year history of sacrococcygeal pain, accompanied by difficulty in urination and defecation for 1 month. Computed tomography and magnetic resonance imaging showed a huge osteolytic and expansile lesion involving the sacrum (Fig. 1). This mass (1820 cm in size) extended anteriorly into the pelvic cavity, compressing the bladder and bowel (Fig. 1). Computed tomography-guided biopsy demonstrated that the tumor was a giant-cell tumor of bone. Preoperative angiography and embolization were used to selectively block the main arteries feeding the tumor (Fig. 2). The patient then underwent a successful marginal resection via an isolated posterior
approach. As often happens with giant-cell tumor [1], the patient had a local recurrence at 30 months. Reference [1] Shen CC, Li H, Shi ZL, Tao HM, Yang ZM. Current treatment of sacral giant cell tumour of bone: a review. J Int Med Res 2012;40: 415–25.
Kai Zhang, MDa Kangwu Chen, MDa Ming Zhou, MDb Hao Chen, MDa Jian Lu, PhD, MDa Huilin Yang, PhD, MDa a Department of Orthopedic Surgery The First Affiliated Hospital of Soochow University No. 188 Shizi St, Suzhou Jiangsu 215006, China
Fig. 1. (A and B) Sagittal and axial computed tomography scans showed the huge expansile mass involving the sacrum and extending into the pelvic cavity. (C and D) Sagittal and axial T2-weighted magnetic resonance imaging revealed the giant tumor with heterogeneous signal intensity. http://dx.doi.org/10.1016/j.spinee.2015.02.007 1529-9430/Ó 2015 Elsevier Inc. All rights reserved.
K. Zhang et al. / The Spine Journal 15 (2015) 1684–1685
1685
Fig. 2. (Left and Right) The arteriogram before and after the arterial embolization. b
Department of Orthopedic Surgery Wuxi Ninth People’s Hospital Affiliated to Soochow University 999 Liangxi Rd, Wuxi Jiangsu 214062, China
FDA device/drug status: Not applicable. Author disclosures: KZ: Nothing to disclose. KC: Nothing to disclose. MZ: Nothing to disclose. HC: Nothing to disclose. JL: Nothing to disclose. HY: Nothing to disclose.
Extremely large giant-cell tumor of sacrum with successful resection via posterior approach A 17-year-old woman presented with a 1-year history of sacrococcygeal pain, accompanied by difficulty in urination and defecation for 1 month. Computed tomography and magnetic resonance imaging showed a huge osteolytic and expansile lesion involving the sacrum (Fig. 1). This mass (1820 cm in size) extended anteriorly into the pelvic cavity, compressing the bladder and bowel (Fig. 1). Computed tomography-guided biopsy demonstrated that the tumor was a giant-cell tumor of bone. Preoperative angiography and embolization were used to selectively block the main arteries feeding the tumor (Fig. 2). The patient then underwent a successful marginal resection via an isolated posterior
approach. As often happens with giant-cell tumor [1], the patient had a local recurrence at 30 months. Reference [1] Shen CC, Li H, Shi ZL, Tao HM, Yang ZM. Current treatment of sacral giant cell tumour of bone: a review. J Int Med Res 2012;40: 415–25.
Kai Zhang, MDa Kangwu Chen, MDa Ming Zhou, MDb Hao Chen, MDa Jian Lu, PhD, MDa Huilin Yang, PhD, MDa a Department of Orthopedic Surgery The First Affiliated Hospital of Soochow University No. 188 Shizi St, Suzhou Jiangsu 215006, China
Fig. 1. (A and B) Sagittal and axial computed tomography scans showed the huge expansile mass involving the sacrum and extending into the pelvic cavity. (C and D) Sagittal and axial T2-weighted magnetic resonance imaging revealed the giant tumor with heterogeneous signal intensity. http://dx.doi.org/10.1016/j.spinee.2015.02.007 1529-9430/Ó 2015 Elsevier Inc. All rights reserved.
K. Zhang et al. / The Spine Journal 15 (2015) 1684–1685
1685
Fig. 2. (Left and Right) The arteriogram before and after the arterial embolization. b
Department of Orthopedic Surgery Wuxi Ninth People’s Hospital Affiliated to Soochow University 999 Liangxi Rd, Wuxi Jiangsu 214062, China
FDA device/drug status: Not applicable. Author disclosures: KZ: Nothing to disclose. KC: Nothing to disclose. MZ: Nothing to disclose. HC: Nothing to disclose. JL: Nothing to disclose. HY: Nothing to disclose.
