case_images: PMC11446914_01
case_images: Imaging at the time of initial diagnosis (2022-01). (A1-B2) X-ray of the thoracic spine. CT: Decreased density of T10 vertebral body, destruction of the vertebral bone, and discontinuity of the bone cortex; (C1-C4) MRI of the thoracic spine: centric flattening of the T10 vertebral body, heterogeneous signal changes within the vertebral body, dural compression, and narrowing of the spinal canal; (D) Puncture pathology: a large number of osteoclasts can be seen with the invasion of normal bone tissue, indicative of giant cell tumor of the bone.
case_images: fonc-14-1402550-g001.jpg
case_images: PMC11446914_01_fonc-14-1402550-g001.jpg
case_images: f1
case_images: T10 vertebral body with abnormal bone destruction. The magnetic resonance imaging (MRI) displayed flattening of the T10 vertebral body with uneven signal changes and compression of the spinal canal ( Figures 1A1-C4 ). T10 vertebral tumor showed aspiration pathology, indicating GCTB ( Figure 1D ). The cumulative observations of the abovementioned clinical manifestations and examination outcomes led to the preliminary diagnosis of T10 vertebrae GCTB.
case_images: Preoperative imaging after 3 doses of denosumab (2022-03). (A1-B3) X-ray of the thoracic spine. CT: Bone density of the T10 vertebral body was significantly improved relative to that previously, uneven ossification was observed within the vertebral body, and bone formation was evident at the posterior margin of the vertebral body; (C1-C4) MRI of the thoracic spine: vertebral signal inhomogeneity was altered, tumor size is reduced, and intravertebral occupancy was improved.
case_images: fonc-14-1402550-g002.jpg
case_images: PMC11446914_01_fonc-14-1402550-g002.jpg
case_images: f2
case_images: T10 vertebral body with abnormal bone destruction. The magnetic resonance imaging (MRI) displayed flattening of the T10 vertebral body with uneven signal changes and compression of the spinal canal ( Figures 1A1-C4 ). After 3 weeks of medication, imaging was reviewed: the T10 vertebral body tumor was observed to be significantly smaller than earlier, partially ossified ( Figures 2A1-C4 ). After the examination of the c-arm X-ray machine, the position of the internal fixation is satisfactory, a titanium rod was implanted, the drainage was left in place, and the incision was sutured ( Figures 3A1, A2 ). The radiographs were reviewed 1 month after the surgery and displayed a satisfactory position of the internal fixation ( Figures 3C1, C2 ), as such the use of denosumab was resumed.
case_images: Surgery-related imaging. (A1) Intraoperative photos (2022-03): Microwave inactivation of vertebral tumors; (A2): Implanted titanium cage;. (B) Postoperative pathology: focal new bone formation can be seen, with some areas of degenerative-like necrosis of the bone tissues. (C1-C2) Postoperative X-rays (2022-04); A satisfactory position of the internal fixation can be seen.
case_images: fonc-14-1402550-g003.jpg
case_images: PMC11446914_01_fonc-14-1402550-g003.jpg
case_images: f3
case_images: T10 vertebral body with abnormal bone destruction. The magnetic resonance imaging (MRI) displayed flattening of the T10 vertebral body with uneven signal changes and compression of the spinal canal ( Figures 1A1-C4 ). After 3 weeks of medication, imaging was reviewed: the T10 vertebral body tumor was observed to be significantly smaller than earlier, partially ossified ( Figures 2A1-C4 ). After the examination of the c-arm X-ray machine, the position of the internal fixation is satisfactory, a titanium rod was implanted, the drainage was left in place, and the incision was sutured ( Figures 3A1, A2 ). The postoperative pathology was consistent with GCTB ( Figure 3B ). The radiographs were reviewed 1 month after the surgery and displayed a satisfactory position of the internal fixation ( Figures 3C1, C2 ), as such the use of denosumab was resumed.
case_images: Review MRI at 24 months after the surgery (2024-03): (A1-A4) Internal fixation artifacts can be seen in the T10 vertebral body, with no abnormal signal in the spinal canal and a normal sagittal diameter.
case_images: fonc-14-1402550-g004.jpg
case_images: PMC11446914_01_fonc-14-1402550-g004.jpg
case_images: f4
case_images: T10 vertebral body with abnormal bone destruction. The magnetic resonance imaging (MRI) displayed flattening of the T10 vertebral body with uneven signal changes and compression of the spinal canal ( Figures 1A1-C4 ). After 3 weeks of medication, imaging was reviewed: the T10 vertebral body tumor was observed to be significantly smaller than earlier, partially ossified ( Figures 2A1-C4 ). A repeat MRI was conducted in March 2024, which revealed no significant abnormalities ( Figures 4A1-A4 ).