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The exploration of surgical outcomes in patients with giant cell tumor of the tendon sheath in spine: An epidemiological, radiological, and follow-up investigation

  • Author Footnotes
    1 These authors contribute equally to this work.
    Jun Shen
    Footnotes
    1 These authors contribute equally to this work.
    Affiliations
    Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China
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  • Author Footnotes
    1 These authors contribute equally to this work.
    Jian Jiao
    Footnotes
    1 These authors contribute equally to this work.
    Affiliations
    Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China
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  • Author Footnotes
    1 These authors contribute equally to this work.
    Nanzhe Zhong
    Footnotes
    1 These authors contribute equally to this work.
    Affiliations
    Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China
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  • Yu Guan
    Affiliations
    Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China
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  • Da Wang
    Affiliations
    Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China
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  • Jinhui Xu
    Affiliations
    Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China
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  • Zeyu Dai
    Affiliations
    Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China
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  • Xiaoyu Ma
    Affiliations
    Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China
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  • Minglei Yang
    Affiliations
    Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China
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  • Haohan Zhou
    Affiliations
    Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China
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  • Zhipeng Wu
    Affiliations
    Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China
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  • Xinghai Yang
    Affiliations
    Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China
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  • Tielong Liu
    Affiliations
    Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China
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  • Haifeng Wei
    Affiliations
    Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China
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  • Jianru Xiao
    Correspondence
    Corresponding author.
    Affiliations
    Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China
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  • Author Footnotes
    1 These authors contribute equally to this work.

      Highlights

      • Spinal GCTTS mainly involves the posterior bone elements with the onset around 30–40 years old.
      • Soft tissue masses centering on the facet joint with osteolytic bony destruction.
      • A few cases presented as the intramuscular lesions without bone destruction.
      • T2-weighted dark signals, homogeneous or heterogeneous enhancement.
      • Gross-total resection is an effective means for treating spinal GCTTS.

      Abstract

      Purpose

      This study aimed to characterize giant cell tumor of the tendon sheath (GCTTS) in spine more fully and further validate the therapeutical effect of surgcial resection for treating this neoplasm.

      Methods

      Patients diagnosed with spinal GCTTS and received surgical resection in our hospital between January 2009 and September 2021 were identified retrospectively. The clinical data and radiological images were summarized and the clinical outcomes of patients with a follow-up period of more than 12 months were analyzed.

      Results

      Thirty patients with benign GCTTS and one with malignant GCTTS were included. Preoperative radiological images were available in 28 of 30 benign cases. Benign lesions were revealed as soft tissue masses centering on the facet joint with osteolytic bone destruction in 26 patients on CT, and as prevertebral or intramuscular masses without bone erosion in 2. MRI showed the signal of isointensity or hypointensity on T1 weighted images (T1WI) in 25 patients and slightly hyperintense in three. On T2 weighted images (T2WI), 17 lesions displayed homogeneous hypointense signal, and eight lesions possessed heterogeneous signals. The remaining three lesions featured slightly hyperintense signal on T2WI. Follow-up data were available in 23 of 30 benign cases treated with gross-total resection, and two patients experienced recurrence.

      Conclusions

      Spinal GCTTS should be suspected in cases with features such as the mass mainly involving the posterior bone elements, the lack of intralesional calcification, T2-weighted dark signals, and free of any cancer. Gross-total resection is an effective means for treating spinal GCTTS.

      Keywords

      Abbreviations:

      GCTTS (Giant cell tumor of the tendon sheath), CT (Computerized tomography), MRI (Magnetic resonance imaging), PET-CT (Positron emission computed tomography), CSFR-1 (Colony-stimulating factor 1 receptor), T1WI (T1 weighted images), T2WI (T2 weighted images)
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