Giant cell tumor: a case report of recurrence during pregnancy.
METHODS
Descriptive.


OBJECTIVE
To report a case of a recurrent giant cell tumor (GCT) of the lumbar spine during pregnancy.


BACKGROUND
GCT is a locally aggressive tumor that primarily occurs in young female adults. These tumors rarely present in the spine, recur locally, and may be present during pregnancy because of growth promoting receptors.


METHODS
A 31-year-old pregnant woman presented to us from Europe at 24 weeks' gestation (G1P1) with severe back pain and an enlarging mass. A large, firm, nontender mass was palpable in the right upper quadrant. Radiographs of the lumbar spine were obtained and revealed a 10-cm x 8 cm x 15 cm expansive bony mass at L2 with vertebral body collapse and junctional kyphosis. Following delivery of a healthy 6 lb. 8 oz. baby, MRI, CT, and full-length standing radiographs were obtained. A needle-guided biopsy showed amorphous bone with numerous giant cells consistent with a GCT. At 6 weeks postpartum, the tumor was resected.


RESULTS
At 1-year follow-up, there is no evidence of local reoccurrence and the patient is without constitutional symptoms.


CONCLUSIONS
This is an unusual presentation of an expanding intra-abdominal mass originating from the lumbar spine during pregnancy. It most likely represents rapid growth of a previous unrecognized recurrence of a GCT. Close observation and follow-up CT scanning are imperative to identify and treat GCTs of the spine before rapid growth occurs.
Ross
Amy E
AE
Department of Orthopaedics and Rehabilitation, Orthopaedic Surgery Service, Walter Reed Army Medical Center, Washington, DC 20307, USA. amy.ross@na.amedd.army.mil
Bojescul
John A
JA
Kuklo
Timothy R
TR
D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D018212:Giant Cell Tumor of Bone / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D011859:Radiography; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D013131:Spine / Q000473:pathology; D016896:Treatment Outcome