Anusitviwat C.Ruangchainikom M.Korwutthikulrangsri E.Sutipornpalangkul W.Mahidol University2023-06-202023-06-202022-05-12BMJ case reports Vol.15 No.5 (2022)https://repository.li.mahidol.ac.th/handle/20.500.14594/87304There 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.MedicineArticleSCOPUS10.1136/bcr-2022-2488372-s2.0-851306329321757790X35550320