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Correlation between imaging tests and anatomicopathological and immunohistochemical characteristics in a case of severe giant cell tumor of bone located at spine

Giant Cell Tumor (GCT) is a benign tumor, with a recurrence rate of about 20% - 34% of the cases. It is usually located at long bone epiphysis. The objective of this study is to report a GCT case in a vertebra, which was early diagnosed as Aneurysmal Bone Cyst (ABC), and to discuss potential differential diagnosis, correlating them to patterns shown on imaging tests. This patient is a 37 year-old female, with clinical picture of pain in spine and paraparesis that started two months earlier. An early diagnosis of ACB was delivered. At X-ray, the injury was lithic, with erosion and cortical destruction. Tomography and resonance showed a cystic and hemorrhagic injury, extending to soft parts. Slides review and the analysis of dried surgical matter submitted to HE and immunohistochemical staining with p53 marker allowed for GCT diagnosis. Many benign lesions present with multi-nucleated giant cells. Imaging tests not always enable a conclusive diagnosis. A definite GCT diagnosis depends on anatomicopathological test, with careful evaluation of the stromal component and positive immunoexpression for p53 protein. Treatment is delivered as surgical resection, with wide margins, followed by instrumentation in cases of tumors located at spine.

Giant Cell Tumor; Spine; Immunohistochemistry


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