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Age / Sex : /
Age / Sex : 33/M
Chief complaint : Neck pain Onset- 2 months ago
1) What is your impression?
Two weeks later, you can see the final diagnosis with a brief discussion of this case.
* Send Application Answers to Ja-Young Choi, MD (drchoi01@radiol.snu.ac.kr)
Courtesy : Young-sook Kim, MD. Department of Radiology, Chosun University Hospital
Diagnosis: Giant cell tumor
Discussion
Findings:
C-spine lateral; Expansile osteolytic lesion is noted at body of C2 extending to odontoid process
CT; Expansile, markedly osteolytic bone lesion is noted in body of C2, base, both pedicle and neural arch of odontoid process.ㅁ Cortical margin is relatively spared.
MR; Iso-signal intensity on T1WI osteolytic lesion is noted at body of C2 This lesion shows high signal intensity with fluid-fluid level on T2WI and heterogenous enhancement. On sagittal reconstruction image, this expansile osteolytic lesion is extended to pedicle, posterior element and odontoid process. Cortical margin is preserved.
Differential Diagnosis:
Aneurysmal bone cyst
Multiple myeloma
Metastasis
Diagnosis: Giant cell tumor
Discussion:
Giant cell tumor of the spine -> 5% of all GCT
Younger than long bone lesion
Site; sacral body(mc) other vertebral body
F:M=3:1
Expansile, osteolytic lesion Fluid-fluid level
15~20% malignant change
References:
1. Mirra JM, Rand F, Rand R, Calcaterra T, Dawson E: Giant-cell tumor of the second cervical vertebra treated by cryosurgery and irradiation. Clin Orthop Relat Res 154:228-233, 1981.
2. Raphael R. Goldenberg, Crawford J. Campbell, Michael Bonfiglio: Giant-cell tumor of bone. J. Bone Joint Surg 52A:619-664, 1970
3. Nicola Di Lorenzo, Piervittorio Nardi, Ciappetta, and Aldo Fortuna. Benign tumors and tumorlike conditions of the spine. Surg Neurol 1986;25:449-56
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