Spinal giant cell tumour presenting as a posterior mediastinal mass

Posterior mediastinal masses frequently originate from neurogenic tumours; however, other possible causes include vascular abnormalities, cysts and primary bone tumours. We present a case involving a man in his 20s who experienced back pain, sudden sensorimotor weakness in both lower limbs and loss of bladder control. Imaging studies, including CT and MRI, identified a posterior mediastinal extramedullary mass associated with vertebral destruction and intrathecal extension. A biopsy of the mass confirmed it to be a giant cell tumour of bone. The patient was treated with denosumab, steroids and spinal decompression and was scheduled for definitive surgery. In young individuals presenting with a posterior mediastinal mass, signs of inflammation and early neurological symptoms, it is essential to consider primary bone tumours as a possible diagnosis.