Tenosynovial giant cell tumor at the upper cervical spine likely arising from the posterior atlantoaxial membrane: A great radiological mimic

Abstract

Although tenosynovial giant cell tumor (TSGCT) is commonly found in the limbs along tendon sheaths, bursae, and synovial joints, its occurrence in the axial skeleton is rare. Majority of the cases of TSGCT of the spine reported in the English literature were found to arise from the spinal facet joints. We report a rare case of TSGCT in the upper cervical spine likely arising from the posterior atlantoaxial membrane, complete with detailed magnetic resonance imaging (MRI) and computed tomography (CT) findings, and an approach to CT-guided biopsy of such paraspinal lesions.