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Year : 2022  |  Volume : 19  |  Issue : 1  |  Page : 48-50

Unresectable giant cell tumor of cervical spine

1 Department of Spine Surgery, Baby Memorial Hospital, Kozhikode, Kerala, India
2 Department of Orthopaedics, Baby Memorial Hospital, Kozhikode, Kerala, India

Correspondence Address:
Premdeep Dennison
Department of Spine Surgery, Baby Memorial Hospital, Kozhikode, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/joasis.joasis_20_22

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Giant cell tumors (GCTs) of the spine occurs very rarely above the sacrum. They are even rarer in cervical spine. The complete resection of the tumor is often unachievable in cervical spine due to the close proximity of important neurovascular structures. We describe a case of unresectable (GCT) of cervical spine treated with near-total resection and adjuvant denosumab therapy. A 28-year-old female presented with quadriparesis and imaging showed GCT of the C6 vertebral body, compressing the spinal cord and also abutting the vertebral artery on the left side. Vertebral arteries were dominant on both sides and the feeders to the tumor could not be embolized. This posed a major challenge as removal of the tumor was not feasible. Near-total removal was done and the patient was started on denosumab, which decreases the osteoclast production and thus reduces size and prevents further spread of tumor. GCTs are resilient and can recur locally, even after the complete removal of tumor. Denosumab is a novel monoclonal antibody which can decrease the size of the tumor and also decrease the chance of recurrence after surgery, by preventing osteoclastogenesis. In cases of GCTs which cannot be completely removed, denosumab therapy as an adjunct to surgical removal is a safe and reliable option.

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