Objective To investigate the clinical symptoms experienced by patients with thoracic spinal tumors and verify the associated symptoms that are predictive of a decline in muscle strength in the lower limbs. Methods A single-center, retrospective cross-sectional study was conducted on in-patients diagnosed with epidural thoracic spinal tumors between January 2011 and May 2021. The study involved a review of electronic medical records and radiographs and the collection of clinical data. The differences in clinical manifestations between patients with constipation and those without constipation were analyzed. Binary logistic regression analyses were performed to identify risk factors associated with a decline in muscle strength in the lower limbs.Results A total of 227 patients were enrolled, including 131 patients with constipation and 96 without constipation. The constipation group had a significantly higher proportion of patients who experienced difficulty walking or paralysis compared to those without constipation prior to surgery (83.2% vs. 17.7%, χ2 = 99.035,P < 0.001). Constipation (OR = 9.522, 95%CI: 4.150-21.849, P < 0.001) and urinary retention (OR = 14.490, 95%CI: 4.543-46.213, P < 0.001) were independent risk factors for muscle strength decline in the lower limbs. Conclusions The study observed that patients with thoracic spinal tumors who experienced constipation symptoms had a higher incidence of lower limb weakness. Moreover, the analysis revealed that constipation and urinary retention were independent risk factors associated with a preoperative decline in muscle strength of lower limbs.

目的 探究不同雌激素浓度对rhBMP-2干预下乳腺癌MCF-7细胞增殖、迁移、侵袭和细胞周期的影响。方法 本实验根据处理MCF-7细胞的rhBMP-2、noggin（BMP-2拮抗剂）以及不同雌激素浓度将细胞进行分组。采用MTT试验检测不同作用条件下MCF-7细胞的增殖能力，Transwell迁移试验及侵袭试验评估不同作用条件下细胞迁移及侵袭能力，利用流式细胞仪检测细胞周期并应用qRT-PCR技术对细胞周期蛋白水平进行定量分析。结果 较低浓度的雌激素对rhBMP-2干预后的MCF-7细胞增殖有抑制作用，而高浓度的雌激素对rhBMP-2干预后的MCF-7细胞增殖有促进作用。不同浓度的雌激素均可促进rhBMP-2干预后MCF-7细胞的迁移，其中部分浓度具有统计学意义。不同浓度的雌激素对于rhBMP-2干预后MCF-7细胞的侵袭能力有抑制趋势，但均无统计学差异。RhBMP-2和noggin可不同程度影响G1期，不同雌激素浓度对细胞周期并无显著性影响。不同浓度雌激素处理下基因CDK2、CDK4、cyclinD1、cyclinE、p21转录水平有所差异。结论 低浓度的雌激素可协同rhBMP-2对乳腺癌MCF-7细胞增殖产生抑制作用，而高浓度雌激素则拮抗了rhBMP-2对MCF-7细胞增殖的抑制作用。在rhBMP-2作用的基础上，雌激素可进一步降低MCF-7细胞的迁移能力，但对侵袭能力作用无明显统计学差异。不同雌激素浓度对细胞周期并没有显著影响，但可能影响多种细胞周期蛋白的表达。

目的:探究PUMCⅡb1型青少年特发性脊柱侧凸(AIS)选择性胸弯融合术后即刻肩平衡的影响因素,并构建回归方程以预测术后即刻肩平衡情况.方法:回顾性分析2015年1月至2021年6月诊断为PUMCⅡb1型AIS并行选择性胸弯融合手术的66例患者.以术后即刻影像学肩高(RSH)的绝对值>1 cm为肩失衡标准,分为肩平衡组(n=39)及肩失衡组(n=27).搜集两组患者一般临床资料,测量并计算相关影像学参数,并进行比较;对术后即刻RSH与胸弯矫正度及胸腰弯/腰弯矫正度进行回归分析,构建多元线性回归方程.结果:高Risser征(P=0.029)、术前胸弯Cobb角较大(P=0.033)及术前腰弯柔韧度较差(P=0.025)的AIS患者术后即刻可能更容易出现肩失衡.多元线性回归分析拟合方程为:术后即刻RSH(cm)=0.069×胸弯矫正度(°)-0.058×胸腰弯/腰弯矫正度(°)-0.179.结论:胸弯与胸腰弯/腰弯的矫正度协调性是影响术后即刻肩平衡的重要因素,骨成熟度高、腰弯柔韧性差的患者术后即刻更容易出现肩失衡.

肌少症是一种与衰老相关的疾病,表现为机体肌肉含量减少,肌肉力量减弱和/或活动能力下降,在老年人群中发病率相对较高,影响日常生活质量,同时增加多系统疾病的发生风险.肌少症可造成椎旁肌肉含量的减少及力量减弱,是退行性脊柱疾病发生和发展的危险因素;同时,肌少症被认为可以影响脊柱手术患者的预后,增加院内并发症、术后住院时间及护理成本.本文对肌少症的发病机制、诊断方法及标准,以及治疗方法等多方面进行总结,并着重探讨其在脊柱疾病及脊柱手术中的作用及影响.

青少年特发性脊柱侧凸 ( adolescent idiopathic scoliosis,AIS ) 是一种青少年中最为常见的脊柱三维畸形,其整体发病率约为 1.5％～3.0％,是一种包括冠状面侧凸、矢状面失平衡和在横轴位上椎体旋转在内的复杂脊柱三维畸形 [1-3].AIS 常发生于青春发育期前后,其发病及进展与基因变异、细胞及机体代谢、相关蛋白表达及脊柱生物力学特性等因素密切相关,其病因学至今尚未被完全阐明 [4-5].目前,关于 AIS 病因及发病机制的研究逐步开展,从最初的动物实验到人体组织学研究,从检测激素水平、骨量测定到近年来开展的基因连锁分析和关联分析,已经取得了一定的研究成果,但截至目前,针对 AIS 发病机制的研究结果与结论并不一致,故仍难以完全合理地解释 AIS 的病因及发病机制 [4-5].因此,进一步深入探索 AIS 的病因学及发病机制具有极为重要的意义.

BACKGROUNDLimited case reports of metastatic spinal bladder cancer (MSBC) have been published to date. Owing to the rarity of this condition, it has not been well-studied and it is thus difficult to predict patient prognosis or to plan appropriate clinical treatment strategies for MSBC. This study is by far the largest clinical case series on MSBC worldwide.METHODSSix patients with MSBC were included from January 2010 to May 2020 at the bone tumor center of orthopedics department in Peking Union Medical College Hospital. Clinical information, radiological data, operative notes, and pathological results of all patients were reviewed. Baseline clinical data of all patients were retrospectively analyzed, and regular follow-up was performed postoperatively. Overall survival (OS) was the time from the initial spinal surgery to the death of patients or the end of May 2020, whichever came first.RESULTSAll six patients with MSBC were male patients, with an average age of 68.1±12.8 years. The mean interval between surgery for primary BC and the first discovery of spinal metastases was 15.6 [2-33] months. Overall, nine spinal operations were performed in the six patients. The mean follow-up period was 11.0±4.2 (range: 7-18) months. All patients (100%) died from MSBC during the follow-up period, with a mean OS of 11.0±4.2 (range: 7-18) months.CONCLUSIONSPatients with MSBC had a poor prognosis in this study. Spinal surgery combined with adjuvant therapy may contribute to relieving the clinical symptoms and improve the quality of life of patients. Appropriate surgical treatment options should be selected according to patients' general condition and relevant characteristics of spinal metastases.

先天性颈椎融合畸形,即Klipple-Feil综合征(Klipple-Feil syndrome,KFS),是一种以颈椎融合为特征的先天性疾病.临床上主要表现为短颈、低后发际线与颈部活动受限三联征,并且常合并有骨关节系统、神经系统、泌尿生殖系统、心血管系统畸形等异常表现.KFS的病因学是近年来国内外学者研究的热点,已从胚胎学、遗传学、基因组学等层面进行了深入研究,但迄今为止KFS的病因学及发病机制尚不明确,仍无法用单一理论解释所有患者的发病机制.进一步明确KFS的病因学及致病机制,将为该病的早期筛查、精确诊断及合理治疗提供一定的理论依据.

Objective: This study aimed to design a weighted co-expression network and a breast cancer (BC) prognosis evaluation system using a specific whole-genome expression profile combined with epithelial-mesenchymal transition (EMT)-related genes; thus, providing the basis and reference for assessing the prognosis risk of spreading of metastatic breast cancer (MBC) to the bone. Methods: Four gene expression datasets of a large number of samples from GEO were downloaded and combined with the dbEMT database to screen out EMT differentially expressed genes (DEGs). Using the GSE20685 dataset as a training set, we designed a weighted co-expression network for EMT DEGs, and the hub genes most relevant to metastasis were selected. We chose eight hub genes to build prognostic assessment models to estimate the 3-, 5-, and 10-year survival rates. We evaluated the models’ independent predictive abilities using univariable and multivariable Cox regression analyses. Two GEO datasets related to bone metastases from BC were downloaded and used to perform differential genetic analysis. We used CIBERSORT to distinguish 22 immune cell types based on tumor transcripts. Results: Differential expression analysis showed a total of 304 DEGs, which were mainly related to proteoglycans in cancer, and the PI3K/Akt and the TGF-β signaling pathways, as well as mesenchyme development, focal adhesion, and cytokine binding functionally. The 50 hub genes were selected, and a survival-related linear risk assessment model consisting of eight genes (FERMT2, ITGA5, ITGB1, MCAM, CEMIP, HGF, TGFBR1, F2RL2) was constructed. The survival rate of patients in the high-risk group (HRG) was substantially lower than that of the low-risk group (LRG), and the 3-, 5-, and 10-year AUCs were 0.68, 0.687, and 0.672, respectively. In addition, we explored the DEGs of BC bone metastasis, and BMP2, BMPR2, and GREM1 were differentially expressed in both data sets. In GSE20685, memory B cells, resting memory T cell CD4 cells, T regulatory cells (Tregs), γδ T cells, monocytes, M0 macrophages, M2 macrophages, resting dendritic cells (DCs), resting mast cells, and neutrophils exhibited substantially different distribution between HRG and LRG. In GSE45255, there was a considerable difference in abundance of activated NK cells, monocytes, M0 macrophages, M2 macrophages, resting DCs, and neutrophils in HRG and LRG. Conclusions: Based on the weighted co-expression network for breast-cancer-metastasis-related DEGs, we screened hub genes to explore a prognostic model and the immune infiltration patterns of MBC. The results of this study provided a factual basis to bioinformatically explore the molecular mechanisms of the spread of MBC to the bone and the possibility of predicting the survival of patients.

Objective: Our research aims to discuss the clinical characteristics, treatment methods, and prognostic characteristics of patients with esophageal cancer spinal metastasis. It is one of the largest clinical studies on the disease to date. The purpose is to improve clinicians’ understanding of the clinical features and prognosis of esophageal spine metastases and share our experience in dealing with this entity. Methods: Six patients with spinal metastasis due to esophageal cancer who had received surgical treatment at the bone tumor center of Peking Union Medical College Hospital from January 2010 to January 2020 were selected. The clinical data, surgical records, imaging examinations, pathological reports, and immunohistochemical results of all patients were reviewed by the team. In the study, we applied two surgical treatments, namely open surgery and percutaneous vertebroplasty. Radiotherapy, chemotherapy, and targeted therapy were used as adjuvant treatments. Retrospective analysis of the patient’s basic clinical data was done. Results: All six patients with metastatic spinal esophageal cancer (MSEC) were male with an average age of 58.0 ± 5.3 years. The average duration between the esophageal cancer resection and diagnosis of spinal metastases was 24.8 (2-72) months. Of the six patients, four had spinal metastases located in the thoracic spine and two had metastases located in the lumbar spine. We referred to the revised Tokuhashi score and Tomita score to recommend individualized surgical treatment plans for patients, and fully respected the patients’ wishes. All six patients underwent surgical treatment, a total of six operations, including four percutaneous vertebroplasty and two open surgery. After the operations, the symptoms of the patients improved significantly. During the follow-up, all six patients died of the disease with the average time from spinal surgery to death being 8.8 ± 3.7 months. Conclusions: In general, patients with esophageal cancer spine metastases have a poor prognosis, and the average survival time of these patients often does not exceed 12 months. The combination of surgical treatment and postoperative adjuvant therapy can control symptoms effectively and improve the patient’s quality of life.

PURPOSE:Metastatic spinal pheochromocytoma (MSP) is very rare in clinical practice, with only a few case reports in the literature. Its low incidence makes it profoundly difficult for clinicians to determine appropriate treatment strategies and predict the prognosis. In this study, we analyzed the clinical characteristics, surgical procedure and prognosis of patients with MSP in one of the largest clinical investigations of this entity to date. METHODS:In this study, we conducted a retrospective analysis of the clinical data of 10 patients with MSP who were treated in our department from 2012 to 2020. We performed a total of 14 operations using two types of surgery: open surgery and percutaneous vertebroplasty. RESULTS:Among them, nine patients underwent 14 spinal operations with satisfactory effect and without any perioperative complications. The mean time from the initial operation to detection of spinal metastasis was 85.3 (12-132) months. The average follow-up time was 27.3 months. Disease progression was detected in nine patients, and eight patients (80%) died during the follow-up period. Univariate analysis showed that extraosseous visceral metastasis (P = 0.022), Tomita score (P = 0.027), and number of spinal metastases (P = 0.024) were associated with overall survival (OS). In addition, extraosseous visceral metastasis (P = 0.030), Tomita score (P = 0.013), and number of spinal metastases (P = 0.026) were associated with progression-free survival (PFS). CONCLUSIONS:Surgical treatment is an effective option in treating MSP and plays an important role in improving patients' quality of life, due to its efficacy in relieving pain, reconstruction of stability, and restoration of function. Extraosseous metastasis, Tomita score, and number of spinal metastases are all potential prognostic factors for OS and PFS.

Objective Metastatic spinal differentiated thyroid carcinoma (MSDTC) is relatively rare in the clinic and often overlooked. The objective of the current study is to analyze the clinical characteristics and prognosis of patients with MSDTC who underwent surgical treatment to determine the prognostic factors that affect survival. Methods This study retrospectively analyzed the clinical data and postoperative follow-up results of MSDTC patients who underwent spinal surgery at the Orthopedic Department of Peking Union Medical College Hospital from January 2010 to January 2020. Clinical data and survival time were analyzed by Kaplan–Meier analysis. Results Eleven patients were included, and the average age was 58.3 years (range 37‒74). The average time from the initial surgery to the discovery of spinal metastasis was 42.9 months (range 0‒132), and the average follow-up time was 21.8 months (range 3‒80). Progression was identified in seven patients, and 10 patients (90.9%) died during the follow-up period. Kaplan–Meier analysis showed that extraosseous visceral metastasis (p=0.012), revised Tokuhashi score (p=0.035), Tomita score (p=0.038), and surgical method (p=0.028) were associated with overall survival (OS). In addition, skeletal visceral metastasis (p=0.017), revised Tokuhashi score (p=0.028), Tomita score (p=0.038), and surgical method (p=0.049) were associated with progression-free survival (PFS). Conclusion Surgical treatment is an effective method for treating MSDTC and leads to pain relief, restored function and increased spinal stability. Based on our single-center experience, extraosseous visceral metastasis, revised Tokuhashi score, Tomita score, and surgical methods may be potential prognostic factors for OS whilst visceral metastasis, revised Tokuhashi score, Tomita score, and surgical methods may be potential prognostic factors for PFS.

Objective: The purpose of this study is to provide key information on the clinical characteristics, surgical treatment, and potential prognostic factors in patients with metastatic spinal gynecologic cancer (MSGC), with a view to their application in clinical practice. Methods: From January 2010 to January 2020, we performed a retrospective analysis of 14 patients with MSGC who underwent surgical treatment in a single center. Surgical treatment was performed on 14 patients, and a total of 14 operations were performed. The survival time of patients after spinal surgery was analyzed by Kaplan-Meier and Cox regression analysis. Results: The average age of patients was 51.9 years (range 25.70). The average time from initial surgery to the discovery of spinal metastasis was 60.3 months (2.180), and the average follow-up time was 19.2 months (2.55). Spinal tumor progression was found in 9 patients, and 12 patients (85.7%) died during follow-up. In univariate analysis, extraosseous visceral metastasis (p = 0.024), revised Tokuhashi stage (p = 0.025), Tomita stage (p = 0.005), and number of spinal lesions (p = 0.038) were associated with overall survival (OS). Extraosseous visceral metastasis (p = 0.026), revised Tokuhashi stage (p = 0.014), Tomita stage (p = 0.001), and gynecological cancer type (p = 0.039) were associated with progression-free survival. Conclusion: Surgical treatment is an effective treatment for MSGC and relieves pain, restores function and rebuilds stability. Based on our single-center experience, extraosseous visceral metastasis, revised Tokuhashi stage, Tomita stage, and gynecological cancer type may be potential prognostic factors for OS.

Purpose: Advanced breast cancer commonly metastasises to bone; however, the molecular mechanisms underlying the affinity for breast cancer cells to bone remains unclear. Thus, we developed nomograms based on a competing endogenous RNA (ceRNA) network and analysed tumour-infiltrating immune cells to elucidate the molecular pathways that may predict prognosis in patients with breast cancer. Methods: We obtained the RNA expression profile of 1091 primary breast cancer samples included in The Cancer Genome Atlas database, 58 of which were from patients with bone metastasis. We analysed the differential RNA expression patterns between breast cancer with and without bone metastasis and developed a ceRNA network. Cibersort was employed to differentiate between immune cell types based on tumour transcripts. Nomograms were then established based on the ceRNA network and immune cell analysis. The value of prognostic factors was evaluated by Kaplan-Meier survival analysis and a Cox proportional risk model. Results: We found significant differences in long non-coding RNAs (lncRNAs), 18 microRNAs (miRNAs), and 20 messenger RNAs (mRNAs) between breast cancer with and without bone metastasis, which were used to construct a ceRNA network. We found that the protein-coding genes GJB3, CAMMV, PTPRZ1, and FBN3 were significantly differentially expressed by Kaplan-Meier analysis. We also observed significant differences in the abundance of plasma cell and follicular helper T cell populations between the two groups. In addition, the proportion of mast cells, gamma delta T cells, and plasma cells differed depending on disease location and stage. Our analysis showed that a high proportion of follicular helper T cells and a low proportion of eosinophils promoted survival and that DLX6-AS1, Wnt6, and GABBR2 expression may be associated with bone metastasis in breast cancer. Conclusions: We developed a bioinformatic tool for exploring the molecular mechanisms of bone metastasis in patients with breast cancer and identified factors that may predict the occurrence of bone metastasis.

Augmented reality (AR) technology has been used and is of great benefit to the formulation of operation planning, simulation of operation scheme, improvement of operation outcome and reduction of risk in joint surgery, and also creates favorable conditions for the understanding of common diseases in joint surgery and training of practical operation skills of young orthopedic surgeons.

OBJECTIVE:Thymomas are rare in clinical practice, and cases of metastatic spinal thymoma are extremely scarce, with only a few case reports or case series described in the literature. In this study, we characterized the clinical features, treatment options and prognostic analysis of patients with metastatic spinal thymomas.PATIENTS AND METHODS:This study included seven patients with metastatic spinal thymoma who underwent open surgery or minimally invasive surgery, and adjuvant treatment in a single center of Peking Union Medical College Hospital from 2010 to 2019. The basic clinical data of the patients were analyzed retrospectively. The possible prognostic factors of progression-free survival (PFS) and overall survival (OS) were studied using the Kaplan-Meier method.RESULTS:This retrospective study included six male patients and one female patient, with a median age of 58.4 (47-75) years. The time from initial diagnosis to detection of spinal metastasis was 54.2 (30-108) months. Kaplan-Meier survival analysis showed the number of spinal metastasis and adjuvant therapies were favorable factors for improving OS and PFS in patients with metastatic spinal thymomas.CONCLUSION:Radiation therapy after the primary operation is an efficient adjuvant therapy, since patients who received postoperative radiation treatment have longer OS and PFS than those who receive chemoradiotherapy. The number of spinal metastases seems to be an effective prognostic factor for longer OS and PFS of patients with spinal metastasis of thymoma.

BACKGROUND:This study intends to discuss the clinical features, therapeutic strategies, and patients' prognostic features and to share our expertise in handling this entity. Current research is one of Asia's extensive MSCCA clinical studies until now.METHODS:Four MSCCA patients who were operated in our hospital's bone tumor center from January 2010 to January 2020 were chosen. Our team reviewed a retrospective study of the medical history and records of surgery, imaging data, and pathology reports (both primary and metastatic spinal tumors) of all MSCCA patients. We applied two surgical therapies in this study, including open surgery and percutaneous vertebroplasty. A predetermined analysis of patients' original clinical data was performed, and regular followup was performed after the operation.RESULTS:Of the four patients, one was male and three were female. The age ranged from 60 to 70 years. The time duration between the diagnosis of cholangiocarcinoma (CCA) and the diagnosis of spinal metastases ranged from 0 to 11 months. Spinal metastatic disease was mainly located in the thoracic spine (n=4; 100%), followed by the cervical spine (n=1; 25.0%). Postoperatively, in the four patients, the symptoms improved and the VAS score was decreased. During the follow-up visit, the progression of the local spinal tumors at the site of primary spinal surgery was detected in three patients (75.0%). Three patients died from the disease during the follow-up period, and one patient is still alive. The time ranged from 6 to 13 months for spinal surgery to the patient's death.CONCLUSIONS:Taken together, the prognosis of patients with MSCCA is poor. Surgical treatment can dramatically improve patients' quality of life and helps to extend a patient's survival. In terms of surgical treatment, appropriate surgical treatment should be selected according to the general condition of the patient and the relevant characteristics of spinal metastases.

RATIONALE:Giant thoracic chordoma is a highly unusual disease with no standard curative managements yet. The objective of this study is to report a very rare case of giant thoracic chordoma successfully operated by combination of thoracoscopic surgery together with posterior spinal surgery. The management of these unique cases has yet to be well-documented.PATIENT CONCERNS:A 64-year-old man presented with a 4-month history of continuous and progressive back pain. The patient, who had been diagnosed of sacral chordoma for 2 years, received surgical treatment of posterior sacral tumor resection and instrumentation. A lytic, expanding lesion of the T5 and T6 vertebral and paraspinal region with mild epidural spinal cord compression was identified.DIAGNOSIS:MRI of spine and PET/CT showed spinal cord compression secondary to the epidural component of the T5 and T6 mass, with increased metastatic marrow infiltration of the left T5 and T6 vertebral and paravertebral region, which presented as a solid tumor. Postoperative pathology confirmed the diagnosis of thoracic chordoma.INTERVENTIONS:The patient underwent 1-stage thoracoscopic release of vertebral and paravertebral tumors, posterior resection of T5-T6 vertebral and paravertebral tumors, T4-T7 spinal canal decompression, and T2-T9 pedicle screw fixation procedure via a posterior approach.OUTCOMES:The patient's neurological deficits improved significantly after the surgery, and the postoperative period was uneventful at the 3-month and 6-month follow-up visit. There were no other complications associated with the operation during the follow-up period.LESSONS:Taken together, the lesion's clinical features, imaging results, and pathological characteristics are unique. Combined efforts of specialists from orthopedics, thoracic surgery, neurosurgery, and medical oncology led to the successful diagnosis and management of this patient. Giant thoracic chordoma, although rare, should be part of the differential diagnosis when the patient has a history of sacral chordoma and presents with back pain and radiculopathy. We recommend the posterior approach for spinal decompression of the giant thoracic chordoma when the tumor has caused neurological deficits. One-stage thoracoscopic release or resection of vertebral and paravertebral tumor is also a good choice for surgical treatment.

Abstract Rationale: Benign fibrous histiocytoma with pleural involvement in spinal region is a highly unusual disease with no standard curative managements yet. The objective of this study is to report an extremely rare case of a giant benign fibrous histiocytoma with pleural involvement in spinal region successfully operated by posterior spinal surgery. The management of these unique cases has yet to be well-documented. Patient concerns: A 23-year-old man presented with a 2-month history of continuous and progressive back pain. A giant, expanding lesion of the T7 vertebral and paraspinal region with pleural involvement was identified. Diagnoses: Computed tomography scan and magnetic resonance imaging of spine showed expanding lesion of the T7 vertebral and paraspinal region involving the right thoracic cavity, which presented as a solid tumor. Postoperative pathology confirmed the diagnosis of thoracic benign fibrous histiocytoma. Interventions: The patient underwent thoracic spinal canal decompression, complete tumor resection, pleural defect repair, and T4 to T10 internal fixation procedure via a posterior approach. Outcomes: The patient's symptom improved significantly after the surgery, and the postoperative period was uneventful at the 2-year follow-up visit. There were no complications associated with the operation during the follow-up period. Lessons: In summary, the tumor's clinical features, imaging results, and pathological characteristics are unique. Combined efforts of specialists from orthopedics, thoracic surgery, neurosurgery, pathology, and medical oncology led to the successful diagnosis and management of this patient. Giant benign fibrous histiocytoma with pleural involvement in spinal region, although rare, should be part of the differential diagnosis when the patient presents with back pain and radiculopathy. We recommend the posterior or 1-stage anterior–posterior combined approach for complete resection of the giant thoracic benign fibrous histiocytoma when the tumor has caused severe symptoms or neurological deficits.