This is a hospital-based case report of giant cell tumor of C2 vertebra (axis) in skeletally immature patient. It is difficult to diagnose giant cell tumor both clinically and radiologically therefore to differentiate it from other lesions, molecular and genetic studies are warranted. Initial aggressive surgical resection should be adopted if possible. Since giant cell tumor is a radioresistant and no known chemotherapy is available, therefore an alternative medical treatment should also be explored where resection is not possible. Use of denosumab and bisphosphonate may be best alternative in inoperable cases.
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