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  • Georgia
    Member
    Post count: 4

    Hello Dr. Corenman,

    Thank you for your informative site, it has been a great benefit to me.

    Today, I got an MRI of my Lumbar Spine and after examining the images think it is possible I may have a Giant Cell Tumor in my lumbar spine around the L3-L4. (Of Course, I am waiting for the professionals to tell me for sure, I definitely could be mistaken)

    My follow-up appointment is in a week or so and I wondered if you would tell me what treatment is recommended if this is indeed the case, generally speaking.

    Thank you,

    Georgia

    Donald Corenman, MD, DC
    Moderator
    Post count: 8436

    Giant cell tumors of the spine are rare. These tumors are generally benign (they act locally only) but some can metastasize to other structures like the lungs. These tumors normally need to be resected surgically and the spine reconstructed afterwards. Sometimes, even with surgical resection, these tumors can recur in the same location.

    Since these tumors are so rare, my first thought is that this is not a giant cell tumor but something different. I assume you have a first class surgeon helping you with the diagnosis. Get more eyes than only one set on this problem to comment on diagnosis and treatment.

    Dr. Corenman

    Georgia
    Member
    Post count: 4

    I hope it is too rare for me. I appreciate your good advice Dr. Corenman. I definitely will see if I can have more people diagnose this problem.

    I also did notice that the Psoas Major adjacent to the “tumor” has atrophied. On the sagittal view of the lumbar spine it looks almost exactly like another mri of a thoracic Giant Cell Tumor. On the axial view it has well-defined boundaries and extends from the body of the vertebrae, the pedicle to the articular facet.

    However, I wonder if there are two tumors, because there quite a large round looking tumor on the left side of the Transverse Process on the following image…not sure which vertebrae.

    It is hard to wait…

    Thank you! :)

    Donald Corenman, MD, DC
    Moderator
    Post count: 8436

    The psoas muscle atrophy is unusual even in the face of tumor in a vertebral body. Even if you do have a Giant Cell Tumor, it would be one for the record books to have two different tumor line occupying the adjacent spaces so that would be highly unlikely.

    Dr. Corenman

    Georgia
    Member
    Post count: 4

    Well, it is interesting. I will wait for more information and return to tell you what I discover. Your analysis gives me some relief. Thank you!

    DanD
    Member
    Post count: 1

    Georgia,

    Dr. Corenman’s words about giant cell tumors are spot on. Based on my wife’s giant cell tumor 17 years ago, I’d like to share what I’ve learned.

    My wife suffered from a giant cell tumor 17 years ago. At that time, around 70% of giant cell tumors were reported young women, around 16 to 26 years of age, in the tibia or fibula of the knee joint. I doubt things have changed since then, but I’m not a doctor and my memory and knowledge of the subject are limited.

    Here is what I remember for sure: only a senior member of a surgical staff with specific giant cell tumor experience should perform a biopsy, and the correct biopsy needle should be used. The wrong procedure or needle can cause the tumor to metastasize into the lungs, liver or brain, which could be fatal. Waiting a few weeks to find the right specialist is probably the right option.

    Pregnancy hormones cause giant cell tumors to grow explosively, which could cause them to rupture and then metastasize. Birth control, and especially pregnancy, might be a bad idea until diagnosis is confirmed and the tumor is removed without remission.

    A specialist who deals with giant cell tumors is Dr. Ross Wilkins. He’s in the Denver area and is easy to track down with google. I have no association with him or his office, other than the fact that he saved my wife 17 years ago.

    I hope this is helpful to you!

    Dan

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