title: Giant cell tumor expanded into the thoracic cavity with spinal involvement.
abstract: This article describes a case of a giant cell tumor that expanded into the thoracic cavity and through the spinal canal into the vertebrae. A 36-year-old man presented with a 6-month history of back pain and dyspnea. Plain chest radiographs showed a huge mass accompanied by right pleural effusion. The mass involved the 12th thoracic spine, and the spinal cord was severely compressed. The tumor was resected with a 2-stage procedure. As a first stage to separate the tumor from the anterior vital structures under direct vision, thoracic surgeons performed a right thoracotomy with chest wall reconstruction from the 8th to 11th ribs. The right lung and inferior vena cava were gently retracted, and the tumor was carefully detached from these structures. We were not able to separate the tumor from the right diaphragm due to severe invasion; therefore, we performed partial resection of the right diaphragm with the tumor. After excision of the anterior part of the tumor, the thoracic wall was reconstructed with the right eighth rib and Marlex mesh. When the patient's general condition improved 2 weeks later, spondylectomy by posterior approach was performed. We achieved excision of a giant cell tumor that had expanded into the thoracic cavity and through the spinal canal into the vertebrae. The patient had achieved full rehabilitation with no neurological or respiratory abnormalities at 7 years postoperatively.
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan. demudon@med.kanazawa-u.ac.jp
authors.forename: Satoru
authors.initials: S
authors.lastname: Demura
authors.forename: Norio
authors.initials: N
authors.lastname: Kawahara
authors.forename: Hideki
authors.initials: H
authors.lastname: Murakami
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Akamaru
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kato
authors.forename: Makoto
authors.initials: M
authors.lastname: Oda
authors.forename: Katsuro
authors.initials: K
authors.lastname: Tomita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuchiya
mesh_terms: D000328:Adult; D005870:Giant Cell Tumors / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D013125:Spinal Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D013130:Spinal Stenosis / Q000209:etiology* / Q000601:surgery; D013899:Thoracic Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome