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Sarcoma
Volume 2012, Article ID 410973, 10 pages
http://dx.doi.org/10.1155/2012/410973
Clinical Study

Giant Cell Tumors of the Axial Skeleton

1Department of Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center, WittenHerdecke University, Ostmerheimer Street, 200, 51109 Cologne, Germany
2Department of Orthopedic Surgery, University of Münster, Albert-Schweitzer-Straße 33, 48149 Muenster, Germany
3Department of Clinical Radiology, University of Münster, Albert-Schweitzer-Straße 33, 48149 Muenster, Germany

Received 19 September 2011; Revised 27 October 2011; Accepted 1 November 2011

Academic Editor: Ajay Puri

Copyright © 2012 Maurice Balke et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. We report on 19 cases of giant cell tumor of bone (GCT) affecting the spine or sacrum and evaluate the outcome of different treatment modalities. Methods. Nineteen patients with GCT of the spine ( ) or sacrum ( ) have been included in this study. The mean followup was 51.6 months. Ten sacral GCT were treated by intralesional procedures of which 4 also received embolization, and 3 with irradiation only. All spinal GCT were surgically treated. Results. Two (15.4%) patients with sacral and 4 (66.7%) with spinal tumors had a local recurrence, two of the letter developed pulmonary metastases. One local recurrence of the spine was successfully treated by serial arterial embolization, a procedure previously described only for sacral tumors. At last followup, 9 patients had no evidence of disease, 8 had stable disease, 1 had progressive disease, 1 died due to disease. Six patients had neurological deficits. Conclusions. GCT of the axial skeleton have a high local recurrence rate. Neurological deficits are common. En-bloc spondylectomy combined with embolization is the treatment of choice. In case of inoperability, serial arterial embolization seems to be an alternative not only for sacral but also for spinal tumors.