Multicentric metachronous giant cell tumour of vertebrae and tibia

Background Multiple metachronous giant cell tumours (GCT), occurring in an individual are extremely rare. Purpose A patient presenting with GCT of multiple thoracic and lumbar vertebrae, 14 year subsequent to occurrence of GCT of proximal end of left tibia, is being reported. Study design Case report. Method Forty-year-old male presented with upper motor neuron paraplegia with sphincter involvement and complete sensory involvement below T11 spinal level. There was a surgical scar of resection arthrodesis of left knee for GCT proximal tibia. Radiographs showed compression of T8, T10, T12, L1 and L4 vertebrae. Routine haematological investigations including serum PTH levels were normal. MRI scan and CT scan showed expansile mass lesion and compression of cord at D12 and L1 vertebrae. Posterior decompression and stabilization was performed. Results As the second focus of the disease occurred 14 years after the appearance of initial lesion, the second independent focus of the disease, rather than a metastasis, is the likely cause. Conclusion It is the first reported case of multiple giant cell tumour of the spine above the sacrum.