A 43-year-old man presented with bubbly expansion and rarefaction of t
he body of the seventh cervical vertebra. The lesion involved the righ
t side of the vertebral arch and had a soft-tissue component extending
mainly anterior to the vertebra. Histopathologic examination of the s
pecimen obtained by open biopsy revealed a giant cell tumour. Giant ce
ll tumours of the spine, excluding the sacrum, are rare. Radiographica
lly, they may be confused with metastatic carcinoma, plasmacytoma, lym
phoma, chordoma and even benign lesions, particularly aneurysmal bone
cyst and brown tumour of hyperparathyroidism. However, giant cell tumo
ur occurs mainly in younger patients, involves the vertebral body sele
ctively in most cases and has a bubbly appearance associated with rare
faction and expansion of the vertebral body, characteristics that may
be helpful in the diagnosis.