| Giant Cell Tumor of Sacrum with Rapid Regrowth |
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Won-Seok Choi, M.D., Se-Hoon Kim, M.D., Sang-Dae Kim, M.D., and Jung-Yul Park, M.D. |
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Department of Neurosurgery, Korea University College of Medicine, Seoul, Korea |
| Giant Cell Tumor of Sacrum with Rapid Regrowth |
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Won-Seok Choi, M.D., Se-Hoon Kim, M.D., Sang-Dae Kim, M.D., and Jung-Yul Park, M.D. |
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| Abstract |
We present a patient who had a rapid regrowing of the sacral giant cell tumor within a short period after two practices of surgical resection followed by radiation therapy.
A 17-year-old female presented with pain on both buttocks and perineal numbness. The computed tomography(CT) and magnetic resonance imaging(MRI) revealed a heterogeneously enhanced mass involving the first and second sacral body.
Because of young age and little neurological deficit, she underwent a subtotal tumor removal and tissue diagnosis through laminectomy, and the pathologic diagnosis was giant cell tumor. However, one month after the first surgery, while waiting for the radiation therapy, the follow-up MRI demonstrated a rapid regrowth of the tumor. She underwent the second operation including combined abdominal and posterior sacral resection and radiation therapy of 50Gy was followed. Again, on the follow- up MRI taken a month after the second surgery and radiotherapy, the tumor was regrowing. She underwent the third operation for debulking and additional chemotherapy was followed with adriamycin 50mg/m2. She lived free of evidence of symptom recurrence or tumor regrowth at the 6months after the third operation though residual tumor mass was left.
In cases of giant cell tumor of spine, our experience suggests that the initial surgery should be as aggressive as possible and than radiation therapy and chemotherapy with adriamycin could be effective for tumor control for lesions that are incompletely resected or recurred. |
| Keywords:
Sacral giant cell tumor, Rapid regrowth, Radiation therapy, Adriamycin |
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