Malignant giant cell tumor of soft parts in lumbosacral region

Background: Giant cell tumor of soft parts is a rare neoplasm that mainly affects adulst and the elderly and is usually located in the extremities. Here we report a child with giant cell tumor of soft tissue, which is a very rare condition in childhood.

Clinical presentation: A 5 year old girl presented with a 5 month history of left lower extremity pain. She had developed paraplegia before admission. On examination, mild left lumbosacral swelling and tenderness was found. Abdominal and pelvic CT-Scan revealed an expansile lytic lesion of the left side of sacrum with significant soft tissue component extending toward the left iliac bone. Lumbar MRI revealed a space occupying lesion originating from posterior L5 elements, projecting toward the L1.

Intervention: The patient underwent surgery. A firm epidural hemorrhagic tumor of L5, S1, and S2 with no spinal cord involvement was found. Partial tumor resection (measuring 3*1*0.5 cm in maximal diameter) and laminectomy was done.

Conclusion: Primary giant cell tumors of soft tissue are distinctive, rare neoplasms that exhibit a wide clinicopathologic spectrum similar to osseous GCTs and need to be differentiated from other giant cell rich soft tissue tumors. Recognition of this tumor is important due to its behavior as a low grade malignancy, but this cannot be predicted and metastasis does occur rarely.