RESUMO
The giant cell tumor of bone is a primary neoplasm, which can be locally aggressive, benign or low grade malignant tumors, that is uncommon in the vertebrae above the sacrum and even more rare in the cervical spine. Tumor radical excision, ?en bloc? is considered the ideal treatment, however frequently not doable, mainly in the cervical spine due to critical neurovascular structures involvement. Adjuvant radiotherapy can be used in cases of subtotal resection or tumor relapse, lowering recurrence rates of the tumor. Case report: female patient, 25 years-old, presenting with cervical pain e sensitivity disturbance in her left arm, with diagnosis of bone neoplasm in C3-C5. She underwent subtotal resection of the lesion, confirming the diagnostic of giant cell tumor of bone, cervical spine arthrodesis and adjuvant radiotherapy. On 30-month follow-up, she was out of pain complains with total recovery of the left arm sensibility.
O tumor de células gigantes da coluna é uma neoplasia primária que pode ser localmente agressiva, benigna ou com baixo grau de malignidade, sendo incomum em vértebras acima do sacro e ainda mais raro na coluna cervical. A excisão radical do tumor, ?em bloco?, é considerada o tratamento ideal, entretanto não é sempre factível, principalmente na coluna cervical pelo envolvimento de estruturas neurovasculares críticas. Radioterapia adjuvante pode ser usada em casos de ressecção subtotal ou recidiva tumoral, com redução da recorrência da neoplasia. Relato de caso: paciente do sexo feminino, de 25 anos, com quadro de cervicalgia e disestesia em membro superior esquerdo, com diagnóstico de processo expansivo afetando os corpos vertebrais de C3-C5. Foi submetida à exérese subtotal da lesão, com diagnóstico de tumor de células gigantes, artrodese de coluna cervical e radioterapia adjuvante. Sem recidivas no seguimento em 30 meses.
Assuntos
Humanos , Feminino , Adulto , Fusão Vertebral , Tumores de Células Gigantes/radioterapiaAssuntos
Humanos , Feminino , Adulto , Neoplasias Ósseas , Hemangioma Cavernoso , Tumores de Células Gigantes/diagnóstico , Tumores de Células Gigantes/radioterapia , Diagnóstico Diferencial , Diagnóstico por Imagem , Espectroscopia de Ressonância Magnética , Neoplasias de Tecido Conjuntivo , Coluna VertebralRESUMO
JC:------------ABSTRACT------------------------- P4 Osteoclastoma seen between 1965 and 1984 is presented. All patients received megavoltage therapy using Telecobalt. Tumour dose of 45 Gy to 55.3 Gy in 15 to 18 fractions had been delivered. All patients had quantitation of pre-treatment tumour volume and post-treatment response using a radiographic grid. CT scan measurements have complimented the grid quantitation in recent years. Follow through visits from 5 to 24 years post-treatment (mean follow up 9.2 years) have shown optimum tumor regression, bone recalcification and restitution of joint functions amongst these patients. No case of bone sarcoma has been detected. Our observations lead us to support megavoltage radiation therapy as the treatment of choice for accessible and inaccessible osteoclastoma.