L5 giant cell tumor in 28-year-old female.

Background: Giant cell tumor of bone (GCTB) is a rare benign tumor that may also exhibit aggressive local behavior. Recurrence of GCTB is common even after complete resection. GCTB typically occurs in long bones, and only 2.7% are found in the spine. Here, a 28-year-old female with a magnetic resonance (MR)-documented L5 lumbar spine GCTB presented with a cauda equina syndrome effectively managed with a decompressive laminectomy/L4-S1 fusion.

Case description: A 28-year-old female presented with a 1-year history of lower extremity pain/paresthesia that had exacerbated over the previous 1 month. When the MR imaging revealed cauda equina compression due to a L5 hypodense lesion, the patient successfully underwent a decompressive laminectomy/L4-S1 fusion. The histopathology examination confirmed the presence of a GCTB.

Conclusion: While gross total excision for GCTB is the treatment of choice, for those undergoing only subtotal/partial resections, additional adjuvant therapy may be warranted. Notably, even despite extensive resections, these lesions have a high rate of recurrence.