Giant Cell Tumor Of Thoracic Spine Misdiagnosed As Hemangioma: Report Of A Case And Review Of Literature

Giant cell tumors (GCTs) of the bone are neoplasms that may be locally aggressive and are located primarily in the epiphysis or meta-epiphysis of long bones. GCTs of the thoracic vertebra are rare, easily misdiagnosed, and infrequently reported; therefore, it is essential to improve the awareness of clinicians with respect to the occurrence of GCTs in thoracic vertebra. Herein, we describe a case involving a 39-year-old man who was diagnosed with hemangioma of the T12 vertebra and who underwent percutaneous kyphoplasty (PKP). Three weeks post-surgery, he experienced progressively worsening weakness and numbness in both lower extremities, with gait instability. He was subsequently admitted to our hospital. Posterior spinal cord decompression of the T11-T12 vertebrae, bone graft fusion and pedicle screw fixation were performed. The patient recovered from the operation. The patient's pathology results were suggestive of a GCT. No recurrence of symptoms was observed during the subsequent 12 months. We reviewed 15 cases (including ours) of GCTs of the thoracic spine in English language studies published beginning in 2005. GCTs exhibited a 1.5:1 female predominance and primarily affected individuals in their thirties. The T8-T12 vertebrae were the most common sites of GCTs of the thoracic spine. One case was a misdiagnosis. Two cases were missed diagnoses because biopsies were not performed. A biopsy must be performed to reduce the rates of misdiagnosis and missed diagnosis of GCTs of the thoracic spine. Fine needle aspiration cytology (FNAC) is an effective method of diagnosing bone lesions and has become more widely accepted.