title: Giant-cell tumors of the cervical spine: case report.
abstract: OBJECTIVE
  Giant-cell tumors of bone are rare, benign neoplasms that occur infrequently in the spine above the sacrum, and their presence in the cervical vertebrae is even more exceptional. Although complete en bloc surgical resection is difficult in the cervical spine, treatment with adjuvant radiotherapy has been considered controversial because of a small risk of malignant transformation. The authors report two cases of giant-cell tumors in the cervical vertebrae that were treated successfully with surgical excision and postoperative radiation as well as long-term follow-up.
  
  
  METHODS
  Both patients presented with neck pain radiating into the upper extremities. In both cases, plain radiography, computed tomographic scanning, and magnetic resonance imaging revealed a large destructive process in the vertebral body.
  
  
  METHODS
  In one case, the tumor was treated by anterior resection, then by laminectomy and instrumented fusion, and finally by adjuvant postoperative radiotherapy. In the second case, treatment consisted of radical anterior and posterior resection with instrumented fusion. However, the tumor recurred, and, after several surgical procedures, external beam radiotherapy was administered. The patients have been followed for 17 and 11 years, respectively, with no evidence of tumor recurrence.
  
  
  CONCLUSIONS
  Radical resection of giant-cell tumors is generally agreed to be the best treatment option. However, complete resection is often not a feasible option for tumors in the cervical spine because of involvement of critical neurovascular structures. In these cases, the benefits of radiotherapy to reduce the risk of local recurrence may well outweigh concerns about the treatment's theoretical risks.
authors.affiliation: Department of Neurosurgery, New York Medical College, Munger Pavillion, Valhalla, NY 10595, USA.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Hunter
authors.forename: Donato
authors.initials: D
authors.lastname: Pacione
authors.forename: Mark
authors.initials: M
authors.lastname: Hornyak
authors.forename: Raj
authors.initials: R
authors.lastname: Murali
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D018212:Giant Cell Tumor of Bone / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D011859:Radiography; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome