[Giant cell tumor of the C2 colonized by an aneurismal bone cyst. Report of case].
Giant cell tumor is colonized by aneurismal bone cyst in only 15% of cases and cervical localisation accounts for less than 1% of giant cell tumors. We are reporting a rare case of a C2 hypervascularized giant cell tumor colonized by an aneurismal bone cyst treated with an effective preoperative Onyx embolization followed by a full tumor resection. The patient experienced a moderate cervical spine injury 2 months prior admission followed by a progressive stiff neck and cervicalgia. CT and MRI identified a lytic lesion of the body and lateral masses of the C2 with encasement of both vertebral arteries. The angiography showed a hypervascularization of the lesion from the vertebral and external carotid arteries as well as a thrombosis of the V3 segment of the right vertebral artery at the C1 level. A posterior occipito-C3/C4 fixation and a tumor biopsy were performed. Histopathological examination concluded to a giant cell tumor colonized by an aneurismal bone cyst. Three weeks later, the patient developed a right upper extremity deficit. The MRI showed an increased C1-C2 stenosis and an increase of the hypervascularization. Three sessions of embolization by the onyx were performed. During surgery a near total tumor devascularisation was observed and a complete resection of the tumor was achieved through an anterolateral approach. Reconstruction consisted of a cementoplasty of the C2 body and odontoïd process with an anterior C3-prosthesis plate. The postoperative course was uneventful.
Service de neurochirurgie, hôpital de Hautepierre - hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France.
H
H
Cebula
F
F
Boujan
R
R
Beaujeux
P
P
Boyer
S
S
Froelich
D000061:Accidents, Home; D000328:Adult; D017824:Bone Cysts, Aneurysmal / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001860:Bone Plates; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology* / Q000601:surgery; D004164:Diphosphonates / Q000627:therapeutic use; D004621:Embolization, Therapeutic; D005593:Fracture Fixation, Internal; D005598:Fractures, Spontaneous / Q000209:etiology* / Q000601:surgery; D005870:Giant Cell Tumors / Q000098:blood supply / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D008026:Ligation; D008279:Magnetic Resonance Imaging; D008297:Male; D009809:Odontoid Process / Q000293:injuries* / Q000601:surgery; D013117:Spinal Cord Compression / Q000209:etiology; D016103:Spinal Fractures / Q000209:etiology* / Q000601:surgery; D013125:Spinal Neoplasms / Q000098:blood supply / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013130:Spinal Stenosis / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014103:Torticollis / Q000209:etiology; D014711:Vertebral Artery / Q000473:pathology / Q000601:surgery; D000077211:Zoledronic Acid
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid