Giant cell tumor: a case report of recurrence during pregnancy

Descriptive.

To report a case of a recurrent giant cell tumor (GCT) of the lumbar spine during pregnancy.

GCT is a locally aggressive tumor that primarily occurs in young female adults. These tumors rarely present in the spine, recur locally, and may be present during pregnancy because of growth promoting receptors.

A 31-year-old pregnant woman presented to us from Europe at 24 weeks' gestation (G1P1) with severe back pain and an enlarging mass. A large, firm, nontender mass was palpable in the right upper quadrant. Radiographs of the lumbar spine were obtained and revealed a 10-cm x 8 cm x 15 cm expansive bony mass at L2 with vertebral body collapse and junctional kyphosis. Following delivery of a healthy 6 lb. 8 oz. baby, MRI, CT, and full-length standing radiographs were obtained. A needle-guided biopsy showed amorphous bone with numerous giant cells consistent with a GCT. At 6 weeks postpartum, the tumor was resected.

At 1-year follow-up, there is no evidence of local reoccurrence and the patient is without constitutional symptoms.

This is an unusual presentation of an expanding intra-abdominal mass originating from the lumbar spine during pregnancy. It most likely represents rapid growth of a previous unrecognized recurrence of a GCT. Close observation and follow-up CT scanning are imperative to identify and treat GCTs of the spine before rapid growth occurs.