Massive intestinal hemorrhage resulting from a polypoid tumor in the sigmoid colon: an unusual complication of a giant cell tumor of the fifth lumbar vertebra.
METHODS
Clinicopathologic study of a case of giant cell tumor of the spine.


BACKGROUND
Giant cell tumors of the spine are uncommon, accounting for 1.3-6.5% of all cases in various series. Because of their location, they may cause neurologic deficits. The treatment consists of excision or curettage and has been claimed to give good results.


METHODS
A 33-year-old woman presented with low back pain in 1995; radiologic investigation and biopsy showed features of giant cell tumor involving the fifth lumbar and first sacral vertebrae. Wide excision was performed, but the tumor recurred in 1996 and was curetted. She developed massive intestinal bleeding in 1997 resulting from infiltration of the sigmoid colon by giant cell tumor in the form of a polypoid intraluminal mass. The involved segment of colon was resected, and the patient remained alive, although debilitated, 7 years after initial presentation.


RESULTS
Examination of the tumor in the spine and the colon showed typical histology of giant cell tumor with no evidence of malignant transformation. The involved colon was freely mobile and away from the tumor of the spine.


CONCLUSIONS
Giant cell tumor of the spine can result in unusual complication, massive intestinal hemorrhage in our case, which causes considerable morbidity.
Chow
Louis T C
LT
Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, Shatin, Hong Kong. lchow@cuhk.edu.hk
Kumta
S M
SM
D000328:Adult; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D005870:Giant Cell Tumors / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D017116:Low Back Pain / Q000209:etiology; D008159:Lumbar Vertebrae / Q000473:pathology* / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery; D012086:Reoperation; D012811:Sigmoid Neoplasms / Q000556:secondary* / Q000601:surgery; D013125:Spinal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery