title: Giant cell tumor of fifth lumbar vertebrae: two case reports and review of the literature.
abstract: BACKGROUND
  complete or total en bloc spondylectomy has been recommended for giant cell tumors of the spine. Wide local resection of the fifth lumbar vertebra carries potential risks of major complications because of its anatomical features. Only nine cases of the giant cell tumors involving the fifth lumbar vertebra have been reported in the literature.
  
  
  OBJECTIVE
  to present two cases of giant cell tumor of the fifth lumbar vertebra treated by single-stage combined anterior and posterior tumor resection over 7 years of follow-up.
  
  
  METHODS
  Case report and a review of literature.
  
  
  METHODS
  A 33-year-old female and a 20-year-old female, each diagnosed with giant cell tumor of fifth lumbar vertebra, underwent single-stage tumor resection through a combined posterior and retroperitoneal anterior approach.
  
  
  RESULTS
  The resection of the fifth lumbar vertebra was completed in the first case without major perioperative complications. In the second case, massive bleeding during the anterior procedure for resection of the vertebral body interrupted the total resection of the tumor, resulting in possible residual tumor which required adjuvant radiotherapy. The patients recovered both clinically and neurologically after the operation. Spinal reconstruction was maintained, and no recurrence of the tumor was evident at the 7-year and 8-year follow-up, respectively.
  
  
  CONCLUSIONS
  There was no recurrence of the tumor after the combined single-stage anterior and posterior tumor resection and adjuvant radiotherapy for the second case for over 7 years follow-up. However, complete resection of the vertebra and tumor at the fifth lumbar vertebra is still challenging to accomplish.
authors.affiliation: Rehabilitation Division and Spine Division, Akita University Hospital, 1-1-1 Hondo, Akita 0108543, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Shimada
authors.forename: Michio
authors.initials: M
authors.lastname: Hongo
authors.forename: Naohisa
authors.initials: N
authors.lastname: Miyakoshi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kasukawa
authors.forename: Shigeru
authors.initials: S
authors.lastname: Ando
authors.forename: Eiji
authors.initials: E
authors.lastname: Itoi
authors.forename: Eiji
authors.initials: E
authors.lastname: Abe
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005870:Giant Cell Tumors / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D009984:Orthopedic Fixation Devices; D019637:Orthopedic Procedures; D018714:Radiotherapy, Adjuvant; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome