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J Craniovertebr Junction Spine. 2018 Jul-Sep;9(3):205-208. doi: 10.4103/jcvjs.JCVJS_31_18.

Giant cell tumor with pathological fracture of C2 with C1-C2 instability: A rare case with review of literature.

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Department of Orthopaedics, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India.


Giant cell tumor (GCT) or osteoclastoma is a benign, locally aggressive tumor with a tendency to recur. Involvement of the axial skeleton is very rare and majority of them are seen in the sacrum. The authors report a rare case of a 19-year-old female who presented with a C2 dens GCT with a pathological fracture and atlantoaxial dislocation. The patient was operated in two stages: first stage, with posterior instrumentation and stabilization followed by the second stage, tumor resection by anterior transoral approach. The residual tumor cavity was packed with autologous corticocancellous bone grafts. At a 5-year follow-up, computed tomography scan showed a C1-C2 fusion mass. There was no radiological or clinical evidence of tumor recurrence with the patient having good functional outcome without any neurological deficit.


Fusion; giant cell tumor; pathological fracture; transoral approach

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