We treated two patients with a giant cell tumor of the lumbar vertebra.
Case 1: A 45-year-old male experienced low back and bilateral thigh pain. Metastatic bone tumor involving the L3 vertebral body was suspected, but the tumor origin was not identified. For progressive paralysis, emergency opertion was performed. The intraoperative histologic report confirmed a giant cell tumor. We performed posterior instrumentation and curettage of the tumor followed by anterior iliac bone grafting.
Case 2: A 47-year-old female experienced low back pain, however, no abnormality was seen on plain X-p films. Two years later, low back pain exacerbated, and a pathological fracture of the L1 vertebra was seen on plain X-p films. CT guided biopsy revealed a giant cell tumor. The tumor involved the L1 vertebral body, lamina, and superior edge of the L2 vertebral body. Resection of the tumor and reconstructive surgery with instrumentation were performed.
Giant cell tumors of the spine are rare. Radiation treatment may not be indicated because of the risk of malignant transformation. In general, operations are performed. Operations should aim at complete resection of the tumor, but complete resection is considered difficult for tumors of the spine due to location and extent. In these two cases, operations were performed by combined anterior and posterior approach. Both patients have not shown any evidence of recurrence for seven years and two and a half years respectively.
