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Metastatic behaviour of giant cell tumour of the spine

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Abstract

Lung metastases from giant cell tumours (GCT) of the spine have not been specifically addressed in the literature. We reviewed our cases and compared the incidence, treatment, and outcomes with those from the extremities. Between 1970 and 2006, we identified seven cases (three females and four males) of lung metastases from a total of 51 cases of GCT of the spine (13.7%). Four of the seven patients had presented to our institution with a spine recurrence after previous treatments and the rest developed recurrences later. The treatments for the lung nodules consisted of metastectomy in two and chemotherapy in six patients. At the latest follow-up (ranging from 18 to 126 months), two had died of the disease, two had no evidence of the disease, and three were alive with disease. Our series shows a higher metastatic rate from spine GCT as compared to those from the extremities, but the overall behaviour and treatment outcomes of the lung metastases are similar. When there is a recurrence of GCT, with or without metastases, the local and possibly the metastases should be biopsied to confirm the original diagnosis. Progression of benign GCT into an aggressive sarcoma has been documented, and the method of management should be altered.

Résumé

Les métastases pulmonaires des tumeurs à cellules géantes (GCT) du rachis n’ont jamais été bien étudiées de façon spécifique dans la littérature. Nous avons revu nos observations et comparé l’incidence de ces complications et de leurs traitements avec celles observées au niveau des extrémités. Matériel et méthode: entre 1970 et 2006, nous avons identifié 7 cas (3 femmes et 4 hommes) de métastases pulmonaires sur 51 tumeurs à cellules géantes du rachis (13,7%). 4 de ces 7 patients ont présenté une récidive au niveau de la colonne après traitement et les autres présentaient une récidive beaucoup plus tardive. Résultats: le traitement de ces nodules pulmonaires a consisté en une métastatectomie dans deux cas, une chimiothérapie dans 6 cas. Au plus long suivi (18 à 26 mois), deux patients sont décédés de cette pathologie, 2 semblent indemnes de toute récidive et 3 sont toujours vivant avec la tumeur. En conclusion, notre série montre qu’il existe un taux élevé de métastases dans les tumeurs à cellules géantes du rachis comparée à celle des extrémités mais, le devenir clinique et le traitement des métastases pulmonaires est identique.

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Correspondence to Rakesh Donthineni.

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Donthineni, R., Boriani, L., Ofluoglu, O. et al. Metastatic behaviour of giant cell tumour of the spine. International Orthopaedics (SICOT) 33, 497–501 (2009). https://doi.org/10.1007/s00264-008-0560-9

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  • DOI: https://doi.org/10.1007/s00264-008-0560-9

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