Giant Cell Tumor of the Lumbar Spine with Large Retroperitoneal Extension and Vascular Attachment

Giant cell tumors (GCTs) of the bone, though typically benign and found at the ends of long bones, are rare in the lumbar spine. Despite their benign nature, they can exhibit local aggressiveness and cause pathological fractures and compression. The treatment is individualized, considering anatomical localization, tumor extension, and clinical symptoms. We present the case of a 41-year-old female, a genuinely unique instance of a GCT of the L4 body extending into the retroperitoneum. This rarity in itself is a point of interest. The patient underwent an initial posterior en bloc resection with lumbar arthrodesis, followed by a second anterior L4 corpectomy and anterior cylinder fusion. The combination of radical surgery with adjuvant therapies such as radiotherapy and bisphosphonates has been described to enhance long-term outcomes and reduce recurrence. Still, surgery remains the mainstay of treatment of this entity.