Giant cell tumor of the cervical spine in children

We report what we believe to be the first case to be presented in the literature of a giant cell tumor (GCT) arising in the seventh cervical vertebral body in a girl of almost 10 years of age. The only similar-reported case occurred in the cervical spine of an adolescent. Cervical location of this tumour is rare: spinal cases usually arise in the lumbar or thoracic spine. The patient presented to the emergency department with the following neurological symptoms: reduction of tricipital reflex and lack of straight in the right upper limb. Radiographs revealed lysis of the C7 vertebral body with anterior subluxation of C7 on T1. Further investigations (MRI, CT scan, Total Whole Body Scintigraphy) showed neurovascular involvement (the vertebral artery and C7 and T1 nerve roots were incorporated within the tumoural mass) without secondary lesions. An open biopsy at C6-T1 level was performed; diagnosis was histological: mononucleated spindle cells and osteoclast-like multinucleated cells were identified. Treatment consisted of surgical resection, vertebral stabilisation and chemotherapy. Twenty-four months after surgical resection and chemotherapy, the girl is well without evidence of local or systemic recurrence. Radiation therapy was not performed to avoid the risk of secondary sarcomatous degeneration.