%0 Case Reports
%T Thoracic giant cell tumor after two total en bloc spondylectomies including one emergency surgery: A case report.
%A Liang HF
%A Xu H
%A Zhan MN
%A Xiao J
%A Li J
%A Fei QM
%J World J Clin Cases
%V 12
%N 16
%D 2024 Jun 6
%M 38899300
%F 1.534
%R 10.12998/wjcc.v12.i16.2894
%X <B>BACKGROUND: </B>For patients with acute paraplegia caused by spinal giant cell tumor (GCT) who require emergency decompressive surgery, there is still a lack of relevant reports on surgical options. This study is the first to present the case of an acute paraplegic patient with a thoracic spinal GCT who underwent an emergency total en bloc spondylectomy (TES). Despite tumor recurrence, three-level TES was repeated after denosumab therapy.<BR><B>METHODS: </B>A 27-year-old female patient who underwent single-level TES in an emergency presented with sudden severe back pain and acute paraplegia due to a thoracic spinal tumor. After emergency TES, the patient's spinal cord function recovered, and permanent paralysis was avoided. The postoperative histopathological examination revealed that the excised neoplasm was a rare GCT. Unfortunately, the tumor recurred 9 months after the first surgery. After 12 months of denosumab therapy, the tumor size was reduced, and tumor calcification. To prevent recurrent tumor progression and provide a possible cure, a three-level TES was performed again. The patient returned to an active lifestyle 1 month after the second surgery, and no recurrence of GCT was found at the last follow-up.<BR><B>CONCLUSIONS: </B>This patient with acute paraplegia underwent TES twice, including once in an emergency, and achieved good therapeutic results. TES in emergency surgery is feasible and safe when conditions permit; however, it may increase the risk of tumor recurrence.