Total neurological recovery after surgical decompression and treatment with denosumab of large unresectable spinal giant cell tumour expanding to mediastinum
Issued Date
2022-05-12
Resource Type
eISSN
1757790X
Scopus ID
2-s2.0-85130632932
Pubmed ID
35550320
Journal Title
BMJ case reports
Volume
15
Issue
5
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMJ case reports Vol.15 No.5 (2022)
Suggested Citation
Anusitviwat C., Ruangchainikom M., Korwutthikulrangsri E., Sutipornpalangkul W. Total neurological recovery after surgical decompression and treatment with denosumab of large unresectable spinal giant cell tumour expanding to mediastinum. BMJ case reports Vol.15 No.5 (2022). doi:10.1136/bcr-2022-248837 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/87304
Title
Total neurological recovery after surgical decompression and treatment with denosumab of large unresectable spinal giant cell tumour expanding to mediastinum
Author's Affiliation
Other Contributor(s)
Abstract
There is a controversy over the medical treatment of unresectable spinal giant cell tumour (GCT) regarding dosing and duration. We studied a spinal GCT case that had expanded to the thoracic spinal canal and mediastinum and was successfully treated by surgical decompression and denosumab. A woman in her 30s presented with weakness in both the lower extremities. MRI revealed a large tumour in the posterior mediastinum expanding from the thoracic vertebrae (T3-6), which compressed the spinal cord. The patient underwent urgent spinal decompression with instrumentation and her tissue was sent for a pathology study. Histologically and immunohistochemistry confirmed the diagnosis of GCT. Since it was an unresectable tumour, this patient was treated with denosumab. Her neurological problem resolved after 6 months of treatment. After 4 years of follow-up, the patient displayed no further progression and no side effects from long-term denosumab usage.