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A woman in her 30s presented with weakness in both the lower extremities. MRI revealed a large tumour in the posterior mediastinum expanding from the thoracic vertebrae (T3\u20136), which compressed the spinal cord. The patient underwent urgent spinal decompression with instrumentation and her tissue was sent for a pathology study. Histologically and immunohistochemistry confirmed the diagnosis of GCT. Since it was an unresectable tumour, this patient was treated with denosumab. Her neurological problem resolved after 6\u2009months of treatment. After 4\u2009years of follow-up, the patient displayed no further progression and no side effects from long-term denosumab usage.<\/jats:p>","DOI":"10.1136\/bcr-2022-248837","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T13:12:35Z","timestamp":1653311555000},"page":"e248837","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Total neurological recovery after surgical decompression and treatment with denosumab of large unresectable spinal giant cell tumour expanding to mediastinum"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6730-7486","authenticated-orcid":false,"given":"Chirathit","family":"Anusitviwat","sequence":"first","affiliation":[{"name":"Orthopedics, Prince of Songkla University, Hat Yai, Songkhla, 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