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MRI Findings of Giant Cell Tumors of the Spine

Jong Won Kwon1, Hye Won Chung1,2, Eun Yoon Cho3, Sung Hwan Hong4, Sang-Hee Choi1, Young Cheol Yoon1 and Sang Kyu Yi1

1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.
2 Present address: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-2 dong, Songpa-ku, Seoul 138-736, Korea.
3 Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
4 Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.


Figure 1
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  		Fig. 1A —Giant cell tumor of L5 in 31-year-old woman (patient 2). Sagittal T2-weighted fast spin-echo MR image (TR/TE, 4,000/102) shows tumor as heterogeneous hyperintensity and curvilinear low signal area (white arrows) within mass. There is decrease of vertebral height of L5. Spinal canal extension is indicated by open arrow.

 

Figure 2
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  		Fig. 1B —Giant cell tumor of L5 in 31-year-old woman (patient 2). Contrast-enhanced axial T1-weighted MR image (592/14) shows moderate and heterogeneous enhancement. Tumoral mass involves vertebral body, right transverse process, pedicle, and articular facet with epidural and perivertebral extension. Curvilinear low signal area on T1- and T2-weighted images did not reveal any enhancement.

 

Figure 3
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  		Fig. 2A —Giant cell tumor of sacrum in 48-year-old man (patient 3). Sagittal T2-weighted fast spin-echo MR image (TR/TE, 3,000/105) shows sacrococcygeal involvement of mass with anterior and posterior soft-tissue extension and heterogeneous high signal intensity.

 

Figure 4
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  		Fig. 2B —Giant cell tumor of sacrum in 48-year-old man (patient 3). Axial T2-weighted MR image (4,010/117) shows fluid–fluid level (asterisk) in tumor.

 

Figure 5
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  		Fig. 2C —Giant cell tumor of sacrum in 48-year-old man (patient 3). Sagittal T1-weighted MR image (613/13) shows homogeneous low signal intensity except curvilinear low signal area (arrowheads).

 

Figure 6
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  		Fig. 2D —Giant cell tumor of sacrum in 48-year-old man (patient 3). Enhanced sagittal T1-weighted MR image (576/13) shows marked and heterogeneous enhancement and multiple focal cystic changes (arrows).

 

Figure 7
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  		Fig. 2E —Giant cell tumor of sacrum in 48-year-old man (patient 3). CT scan shows well-defined soft-tissue density with destruction of cortical bone. No calcification is seen within mass.

 

Figure 8
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  		Fig. 2F —Giant cell tumor of sacrum in 48-year-old man (patient 3). Contrast-enhanced CT scan shows that mass enhances.

 

Figure 9
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  		Fig. 2G —Giant cell tumor of sacrum in 48-year-old man (patient 3). Photomicrograph shows that tumor is composed of round-to-oval mononuclear cells and multinucleated giant cells. Giant cells with varying numbers of nuclei are arranged more or less uniformly (arrows). (H and E, x100)

 

Figure 10
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  		Fig. 3A —Giant cell tumor of T5–T7 in 36-year-old man (patient 6). Sagittal T2-weighted fast spin-echo MR image (TR/TE, 2,500/120) shows collapse of T6 vertebra and tumor spread to T5 and T7 vertebrae. Extradural intraspinal mass effect can be seen.

 

Figure 11
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  		Fig. 3B —Giant cell tumor of T5–T7 in 36-year-old man (patient 6). Sagittal reconstructed CT scan shows destruction of cortical bone.

 

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