Table 1: (a) Giant cell tumors of the mobile spine. (b) Giant cell tumors of the sacrum.
(a)

NumberSexAgeSite/neuro statusFUPrimary treatmentRec.Treatment rec.Met. Outcome

1M18 YTh6/OK27 MVentral: intral. res., bone graft, ventral stabilization8 MVentral: intral. res. Th6–Th7, bone graftNEDLoss of sensory function and paresis at Th9 level, footdrop right

2F17 YTh12 / encasing of left nerve root with sensory disorders98 Mdorsal: intral. curettage, dorsal instr. Th10 – L2, transection of nerve root Th12 + bone graft, bone cementNED

3F23 YTh10/infiltration of spinal canal with initial paresthesias83 MDorsoventral: intral. partial res. Th10, dorsal instr. Th9–11, bone graft11 MDorsal: intral. partial res. Th9–Th11, decompression of spinal canal, extension of instrumentation Th8–Th1213 MSDRecovery from paresthesias but local progress, destruction of Th7–Th9, encasing of aorta, displacement of cava and heart, pleural/pericardial effusion, bipulmonary met. treated by chemo
(4 cycles Ifosfamid, Cisplatin) and EBI 46 Gy over 1 M. last FU
constant unresectable met., decrease of local tumor, pregnant

4F26 YTh11/OK24 MDorsoventral: intral. partial res. Th11, dorsal instr. Th10–Th12, bone graft (rib)7 M/13 MVentral: intral. res., bone cement, laceration of aorta, severe bleedingDEBI started after rec., death due to pulmonary failure 13 days after last surgery

5F27 YL4/infiltration of right psoas/spinal canal, encasing right nerve root with sensory disorders32 MDorsoventral: spondylectomy L4, intral. res. soft tissue component, dorsal instr. L3– L5, titanium cage interposition, bone graft16 MNEDOral clodronate (800 mg 2/d), since resection of bipulmonary met., free of complaints

6M30 YL4/infiltration of right psoas muscle and spinal canal causing weakness of right quadriceps45 MDorsoventral: intral. spondylectomy L4, intral. res. soft tissue component, dorsal instr. L3–L5, titanium cage interposition, bone graft9 MNo surgery, serial SAE until complete devascularization 3 times (directly, 1 and 6 M later)SDLocal rec. encasing aorta with loss of sensory function at L4 level, after serial SAE complete recovery of neurological functions, slight regression of tumor on MRI, since rec. daily oral pain medication and clodronate (800 mg 2/d), able to work full time in office

FU: followup, rec.: recurrence, met.: metastasis, M: male/months, F: female, Y: years, Th: thoracal spine, L: lumbar spine, intral.: intralesional, res.: resection, instr.: instrumentation, EBI: external beam irradiation, preop.: preoperative, SAE: selective arterial embolization, Gy: Gray, NED: no evidence of disease, SD: stable disease, D: dead due to disease.
(b)

NumberSexAgeSite /neuro statusFUPrimary treatmentRec.Treatment rec. Outcome

7F25 YSacrum/OK133 MIntral. curettage, bone cement11 MResection of soft tissue recurrenceNEDLocal infection after initial surgery cured by repeated curettage and cementation plus systemic antibiotics, subsequently irritation of left S1 nerve root causing claw toes

8F19 YSacrum/OK124 MIntral. curettage, bone cementNEDLocal infection after initial surgery cured by repeated curettage and cementation plus systemic antibiotics, final FU free of complaints

9M20 Ysacrum, affection of SI joint/OK20 MIntral. curettage, bone cement12 MPreop. SAE, partial intral. res.PDLocal progress 6 M after rec. treated by SAE, another progress after again 6 M treated by EBI 30 Gy over 1 M without effect, at last FU free of pain but progress with incomplete paresis of left foot. Scheduled for denosumab treatment

10F20 YSacrum, infiltration of spinal canal/no neurological deficits62 MIntral. curettage, bone cementSDStable left-over tumor tissue after partial removal, oral clodronate (800 mg 2/d) over 1 Y, last FU free of complaints

11F61 YSacrum/OK24 MIntral. curettage, laminectomy S1–S4, bone cementNEDConus/cauda syndrome since surgery

12F18 YSacrum, crossing of midline/OK49 MIntral. partial res. mainly of soft tissue component, chemotherapy (CWS-96 study ifosfamid, vincristine, adriamycin), EBI 50 Gy over 1 MSDFree of complaints

13M24 YSacrum/OK88 MPreop. SAE, ligation of left and right internal iliac vessels and median sacral artery, curettage, bone graftNEDLocal infection after initial surgery cured by repeated curettage and cementation plus systemic antibiotics, final FU free of complaints

14F32 YSacrum, infiltration of ilium/OK15 MPreop. SAE, curettage, bone cementNEDFree of complaints
15M20 YSacrum, infiltration of spinal canal and spinal cord compression/no neurological deficits28 MPreop. SAE, intral. partial curettage, bone cement, EBI with a special particle accelerator at the DKFZ (“german cancer research center” in Heidelberg, Germany) 66 Gy over 1 MSDFree of complaints, regression of tumor on MRI

16M28 YSacrum, stenosis of spinal canal/ conus/cauda syndrome51 MPreop. SAE, partial curettage, bone cement, EBI 60 Gy over 1 MNEDPersistent rectum/bladder dysfunction, gluteal dysesthesia

17F28 YSacrum large/OK36 MNo surgery, EBI 50 Gy over 1 M21 MNo surgery, EBI 50 Gy over 1 MSDRegression after first EBI but progress after 21 M again treated by EBI + systemic interferon alpha, ongoing oral clodronate (800 mg 2/d) intake since rec.

18F29 YSacrum, large, crossing of midline/OK24 MNo surgery, EBI 55 Gy over 1 MSDslight regression of tumor on CT, free of complaints

19F56 YSacrum/pain both thighs and buttocks, paresthesias of anal/genital area, buttocks, foot soles, rectum/bladder dysfunction17 MNo surgery, EBI 50 Gy over 1 M, SAE 3 M laterSDSignificant regression of symptoms since SAE but still paresthesias both foot soles and moderate bladder dysfunction, daily oral pain medication, oral clodronate (800 mg 2/d) since treatment

FU: followup, rec.: recurrence, M: male/months, F: female, Y: years, intral.: intralesional, res.: resection, EBI: external beam irradiation, preop.: preoperative, SAE: selective arterial embolization, Gy: Gray, NED: no evidence of disease, SD: stable disease.