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Extraarticular paravertebral diffuse-type giant cell tumor.

Naoko Masuzawa·Mitsuo Kishimoto·Minoru Houshimaru
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Abstract

A diffuse-type giant cell tumor (DGCT) of the paravertebral region is a rare condition characterized by an ill-demarcated mass with facet joint involvement. We describe a case of extra-articular DGCT of the paravertebral cervical region without association to the facet joint. A 51-year-old male presented with a headache. Diagnostic imaging showed a dumbbell-shaped mass with enlargement of the right intervertebral foramen between C6 and C7. The tumor was completely resected in multiple fragments with the suspicion that it was a schwannoma. Histologically the tumor consisted chiefly of mononuclear histiocytoid cells, foamy macrophages and multinucleated giant cells, which led to a diagnosis of DGCT. The case alerts one to be aware that DGCT may originate from a paravertebral location as a soft-tissue mass without facet joint involvement.

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Cervical VertebraeDiagnosis, DifferentialFollow-Up StudiesGiant Cell TumorsHeadacheHumansMagnetic Resonance ImagingMaleMiddle AgedNeurilemmomaRare DiseasesSoft Tissue NeoplasmsSpinal Cord NeoplasmsTomography, X-Ray ComputedCase ReportsJournal Article

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Naoko Masuzawa, Mitsuo Kishimoto, Minoru Houshimaru. 2006-03-08. Extraarticular paravertebral diffuse-type giant cell tumor.. https://doi.org/10.1007/s00256-005-0074-0

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Surgical treatment of cervical kyphosis in Larsen syndrome: report of 3 cases and review of the literature.

STUDY DESIGN: A retrospective case series. OBJECTIVE: To review the surgical results for midcervical kyphosis in 3 cases with Larsen syndrome, and to discuss the choice of surgical treatments. SUMMARY OF BACKGROUND DATA: Cervical kyphosis is the most hazardous and serious manifestation of Larsen syndrome due to the risk of life-threatening paralysis, and thus usually requires surgical treatment. However, little information has been reported concerning surgical treatments for this challenging condition. METHODS: Three patients with Larsen syndrome were surgically treated for midcervical kyphosis at our institution. RESULTS: An infant with mild cervical kyphosis was successfully treated with posterior arthrodesis using a halo immobilization, and anterior vertebral growth with a mature posterior fusion mass resulted in spontaneous correction of the kyphosis. In the remaining 2 infants with myelopathic symptoms due to severe and structural kyphosis, anterior decompression and fusion via a lateral approach followed by posterior fusion with segmental spinal instrumentation and halo immobilization resulted in improved neurologic symptoms and solid fusion. CONCLUSIONS: Posterior spinal fusion is only indicated for patients with mild and flexible cervical kyphosis, and anterior decompression and circumferential arthrodesis is required for patients with severe kyphotic deformity, who usually develop myelopathic symptoms. Anterior surgery for such a small patient with severe kyphosis involves much higher risk of spinal cord injury during decompression maneuvers and difficulty in stabilization of the reconstructed cervical spine. Therefore, all patients with Larsen syndrome should be screened with radiographs at the first visit to detect cervical kyphosis early so that posterior alone fusion is possible.

Cervical Vertebrae↗