Giant Cell Tumor of the Mobile Spine Occurring in Pregnancy: A Case Report and Literature Review

Orthopaedic Surgery, 2017 · DOI: 10.1111/os.12333 · Published: May 1, 2017

Simple Explanation

Giant cell tumors (GCTs) are rare, benign but aggressive bone tumors that sometimes occur in the spine. This paper presents a case of a pregnant woman with a GCT in her spine and reviews similar cases. The patient was a 31-year-old woman at 34 weeks of gestation who presented with numbness and weakness in her legs due to a tumor compressing her spinal cord. She underwent a cesarean section to deliver a healthy baby, followed by surgery to remove the tumor. The review of similar cases suggests that it is generally safe to delay tumor treatment until after delivery. Doctors should be aware that GCT symptoms can mimic pregnancy symptoms, and careful monitoring is needed.

Study Duration

2-year follow-up

Participants

One pregnant patient with GCT, review of 8 similar cases

Evidence Level

Case report and literature review

Key Findings

1
GCT in the mobile spine during pregnancy is rare, with only eight cases with detailed clinical data previously reported.
2
Delaying surgery until after delivery appears to be a safe strategy for managing GCT in pregnant women, allowing for fetal development without serious nerve damage.
3
Clinical symptoms of GCT in the mobile spine can be misinterpreted as normal pregnancy symptoms, potentially leading to delayed diagnosis and treatment.

Research Summary

This case report describes a 31-year-old pregnant woman with a giant cell tumor (GCT) in her thoracic spine. The patient underwent cesarean section followed by tumor resection and spinal fusion, with a successful outcome at 2-year follow-up. The study reviews eight similar cases of GCT in the mobile spine during pregnancy, analyzing demographic characteristics, treatment approaches, and prognoses. The review suggests that delaying tumor treatment until after delivery is a reasonable option. The authors emphasize the importance of considering GCT in pregnant women presenting with neurological symptoms, as these symptoms can be masked by normal pregnancy-related changes. Early diagnosis and appropriate management are crucial for both maternal and fetal well-being.

Practical Implications

Diagnostic Awareness

Clinicians should consider GCT in the differential diagnosis of pregnant women presenting with persistent or progressive back pain and neurological symptoms.

Treatment Strategy

For spinal GCT in pregnant women, delaying definitive surgery until after delivery under close observation is a reasonable approach to balance maternal and fetal health.

Surgical Considerations

Definitive surgery after delivery, along with functional rehabilitation, can lead to acceptable outcomes for young patients with spinal GCT and no serious nerve damage.

Study Limitations

1
The study is limited by being a single case report and a review of a small number of similar cases.
2
The follow-up period in the reviewed cases is relatively short, which may not capture long-term recurrence rates.
3
The relationship between pregnancy and GCT growth remains unclear, and further research is needed to understand the underlying mechanisms.

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