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Xue W, Niu J, Chen G, He Y, Du X, Jingqin F. Giant cell tumor of bone of temporal bone and skull base: report of 6 cases. Skeletal Radiol 2024:10.1007/s00256-024-04784-3. [PMID: 39251419 DOI: 10.1007/s00256-024-04784-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 07/26/2024] [Accepted: 08/27/2024] [Indexed: 09/11/2024]
Abstract
OBJECTIVE Five cases of giant cell tumor of bone (GCTB) in the head and neck region were reported, with a main focus on the radiological findings to identify common characteristics for the diagnosis of GCTB in these sites. MATERIALS AND METHODS Five consecutive patients diagnosed with GCTB were retrospectively selected. Radiological features on conventional and advanced MR sequences and CT were analyzed. HE staining and immunohistochemical examination were performed using antibodies against p63 and CD68. RESULTS The common clinical features were local mass (3/5), tinnitus (3/5) and headache (2/5). Radiologically, all the cases were well-circumscribed osteolytic lesion, majority of cases demonstrated an expansile growth pattern and "soap bubble" appearance on CT (4/5). On MRI, the tumors showed predominantly hypointensity both on T1WI and T2WI, and no evidence of restricted diffusion on DWI. Intratumoral hemorrhage (2/5), cystic alternation (2/5) and very low signal on T2WI in the periphery region of the tumor (4/5) was found. Fluid-fluid level was noted in one case, which was eventually verified to be GCTB with secondary aneurysmal bone cyst (ABC). With contrast agent, all the cases showed striking (3/5) or mild to intermediate (2/5) enhancement. CONCLUSIONS Although the above described radiological findings are not specific for GCTB in head and neck region, a well-defined osteolytic lesion in the bones of head and neck region with "soap bubble" appearance on CT and hypointensity on T2WI with very low signal in the peripheral region of the tumor on MRI highly suggest GCTB for patient ages 20 to 40.
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Affiliation(s)
- Wei Xue
- Department of Radiology, the 940Th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, 730000, China
| | - Juanqin Niu
- Department of Radiology, the 940Th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, 730000, China
| | - Gang Chen
- Department of Radiology, the 940Th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, 730000, China
| | - Yao He
- Department of Radiology, the 940Th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, 730000, China
| | - Xuesong Du
- Department of Radiology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China.
- Medical Imaging Research Center, Anhui Medical University, Hefei, 230601, China.
| | - Fang Jingqin
- Department of Ultrasound, Army Medical Center of PLA, Army Medical University, Chongqing, 400024, China.
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Amri R, Chelly A, Ayedi M, Rebaii MA, Aifa S, Masmoudi S, Keskes H. RANKL, OPG, and RUNX2 expression and epigenetic modifications in giant cell tumour of bone in 32 patients. Bone Joint Res 2024; 13:83-90. [PMID: 38368904 PMCID: PMC10875390 DOI: 10.1302/2046-3758.132.bjr-2023-0023.r2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
Aims The present study investigated receptor activator of nuclear factor kappa-Β ligand (RANKL), osteoprotegerin (OPG), and Runt-related transcription factor 2 (RUNX2) gene expressions in giant cell tumour of bone (GCTB) patients in relationship with tumour recurrence. We also aimed to investigate the influence of CpG methylation on the transcriptional levels of RANKL and OPG. Methods A total of 32 GCTB tissue samples were analyzed, and the expression of RANKL, OPG, and RUNX2 was evaluated by quantitative polymerase chain reaction (qPCR). The methylation status of RANKL and OPG was also evaluated by quantitative methylation-specific polymerase chain reaction (qMSP). Results We found that RANKL and RUNX2 gene expression was upregulated more in recurrent than in non-recurrent GCTB tissues, while OPG gene expression was downregulated more in recurrent than in non-recurrent GCTB tissues. Additionally, we proved that changes in DNA methylation contribute to upregulating the expression of RANKL and downregulating the expression of OPG, which are critical for bone homeostasis and GCTB development. Conclusion Our results suggest that the overexpression of RANKL/RUNX2 and the lower expression of OPG are associated with recurrence in GCTB patients.
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Affiliation(s)
- Raja Amri
- Research Laboratory Cell Therapy and Experimental Musculoskeletal System, Faculty of Medicine, Sfax, Tunisia
- Laboratory of Molecular and Cellular Screening Processes, Centre of Biotechnology of Sfax, Sfax, Tunisia
| | - Ameni Chelly
- Laboratory of Molecular and Cellular Screening Processes, Centre of Biotechnology of Sfax, Sfax, Tunisia
| | - Mariem Ayedi
- Laboratory of Molecular and Cellular Screening Processes, Centre of Biotechnology of Sfax, Sfax, Tunisia
| | - Mohammed A. Rebaii
- Research Laboratory Cell Therapy and Experimental Musculoskeletal System, Faculty of Medicine, Sfax, Tunisia
- Department of Orthopedic Surgery and Traumatology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Sami Aifa
- Laboratory of Molecular and Cellular Screening Processes, Centre of Biotechnology of Sfax, Sfax, Tunisia
| | - Sabeur Masmoudi
- Laboratory of Molecular and Cellular Screening Processes, Centre of Biotechnology of Sfax, Sfax, Tunisia
| | - Hassib Keskes
- Research Laboratory Cell Therapy and Experimental Musculoskeletal System, Faculty of Medicine, Sfax, Tunisia
- Department of Orthopedic Surgery and Traumatology, Habib Bourguiba University Hospital, Sfax, Tunisia
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Klienkoff P, Weingertner N, Geyer L, Gros CI, Kurtz JE, Bornert F. Management of a rare mandibular giant cell tumor of bone by neoadjuvant denosumab therapy and surgery: A 4-year follow-up case report. Int J Surg Case Rep 2023; 112:108980. [PMID: 37913666 PMCID: PMC10667875 DOI: 10.1016/j.ijscr.2023.108980] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/12/2023] [Accepted: 10/21/2023] [Indexed: 11/03/2023] Open
Abstract
INTRODUCTION Giant cell tumor of bone (GCTB) is a very rare tumor encountered in the jaws and its histology is quite similar to the more common giant cell granuloma of the jaws (GCGJ). These two entities can be easily confused in maxillofacial region. They are classically managed surgically, but in some localizations and in specific medical-surgical contexts, neoadjuvant therapy with denosumab may be indicated. This report tends to reinforce existing evidence in favor of the use of a neoadjuvant approach, particularly for localization of GCTB in the orofacial region. PRESENTATION OF CASE This is a 57-year-old female patient, an alcoholic smoker, in whom a voluminous mandibular radiolucent lesion was discovered during a routine X-ray by her dentist. After medical imaging assessment and incisional biopsy, diagnosis of GCTB was established. A neoadjuvant denosumab therapy was proposed first followed by a secondary surgical curettage. After 4 years' follow-up, complete healing was observed with no recurrence of the lesion. DISCUSSION Surgical management of aggressive GCTB is risky particularly in localizations involving the sacrum, spine or craniofacial skeleton with a high residual recurrence rate. The use of denosumab to stop tumor progression and facilitate secondary excision surgery is a recent approach that is now well documented in the literature showing promising results with a low rate of side effects. CONCLUSION This case of mandibular GCTB is to our knowledge the unique case described in this localization and treated by denosumab neoadjuvant therapy followed by surgery with a 4-year follow-up showing a complete healing.
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Affiliation(s)
- Pierre Klienkoff
- University of Strasbourg, Faculty of Dental Surgery, 8 Rue de Sainte Elisabeth, 67000 Strasbourg, France; University Hospital Strasbourg, Oral Surgery, Strasbourg, France.
| | - Noëlle Weingertner
- University Hospital Strasbourg, Department of Pathology, Strasbourg, France
| | - Lucas Geyer
- University Hospital Strasbourg, Department of Pathology, Strasbourg, France
| | - Catherine-Isabelle Gros
- University of Strasbourg, Faculty of Dental Surgery, 8 Rue de Sainte Elisabeth, 67000 Strasbourg, France; University Hospital Strasbourg, Dento-maxillary Radiology, Strasbourg, France
| | - Jean-Emmanuel Kurtz
- Department of Medical Oncology, ICANS, 17 rue Calmette, 67200 Strasbourg, France
| | - Fabien Bornert
- University of Strasbourg, Faculty of Dental Surgery, 8 Rue de Sainte Elisabeth, 67000 Strasbourg, France; University Hospital Strasbourg, Oral Surgery, Strasbourg, France; INSERM (French National Institute of Health and Medical Research) UMR 1260, Regenerative Nanomedicine, CRBS, 1 Rue Eugène Boeckel, 67000 Strasbourg, France
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Jha Y, Chaudhary K. Giant Cell Tumour of Bone: A Comprehensive Review of Pathogenesis, Diagnosis, and Treatment. Cureus 2023; 15:e46945. [PMID: 38022126 PMCID: PMC10640696 DOI: 10.7759/cureus.46945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
The benign aggressive tumour known as a giant cell tumour of bone (GCTB) frequently affects the knee bones. Patients suffering from GCTB present with pain, swelling, joint effusion, loss of ability to bear weight on the involved extremity and a restriction in the range of motion of the afflicted joint may also exist, depending on the tumour's size. GCTB makes up 20% of benign skeletal tumours and 5% of all primary bone tumours. Although it has an equal distribution of the sexes, the majority reveal a higher frequency among women. Eighty per cent of GCTB instances were recorded in patients between the ages of 20 and 50 during the third decade. The femur, tibia and radius are where GCTB is most frequently discovered. Lesions can be rated using the Campanacci grading method based on the plain radiograph's results. Plain radiography, CT and MRI are used to diagnose the tumour. Surgery is the only curative treatment which is determined by the Campanacci grade and the tumour's location. Recurrence of GCTB is observed in about 25% of patients, with curettage being associated with rates as high as 50%. We evaluated the GCTB-related articles and summarised the developments in diagnosis, treatment and reducing risk of recurrence.
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Affiliation(s)
- Yash Jha
- Anatomy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Kirti Chaudhary
- Anatomy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Fadili O, Messoudi A, El Adaoui O, El Andaloussi Y, Bennouna D, Fadili M. A remarkable and aggressive aneurysmal bone cyst ravaging the femoral shaft, advancing to lung metastases: An extremely rare case. Int J Surg Case Rep 2023; 108:108414. [PMID: 37352769 PMCID: PMC10382726 DOI: 10.1016/j.ijscr.2023.108414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/04/2023] [Accepted: 06/06/2023] [Indexed: 06/25/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Aneurysmal bone cysts (ABCs) are relatively uncommon tumor-like lesions that require careful management. Reporting such cases is crucial to highlight the importance of understanding the physiopathology and treatment options associated with ABCs. Literature-based writing emphasizes the significance of reporting cases like the one presented here. The aneurysmal bone cyst, classified as a Tumor Rich in Giant Cells according to the latest World Health Organization (WHO) classification of soft tissue and bone tumors, has posed several hypotheses and challenge. This aggressive form and rare localization of this lesion necessitates thorough discussions regarding its management. CASE PRESENTATION We present a compelling case of a 37-year-old patient, without any specific pathological history, with a giant diaphyseal aneurysmal bone cyst located in the right femur. Remarkably, the lesion had been progressing for a decade, leading to extensive destruction of the entire femoral diaphysis despite undergoing previous surgical interventions. The patient's unique circumstances highlight the unpredictable behavior and destructive potential of aneurysmal bone cysts in rare anatomical locations. DISCUSSION AND CONCLUSION This case underscores the need for a comprehensive understanding of aneurysmal bone cysts and their management. The utilization of denosumab, an inhibitor of the RANK/RANKL system, as a medical treatment in conjunction with surgery resulted in a favorable therapeutic response, including a reduction in tumor mass. The current WHO classification, recognizing ABCs as Tumors Rich in Giant Cells, consolidates previous hypotheses and enables the development of new therapeutic protocols. The integration of surgery and medical treatment holds promise for improving outcomes in patients with aneurysmal bone cysts. In conclusion, advancements in understanding the physiopathology and treatment options are crucial for developing effective therapeutic protocols to these aggressive forms of ABCs.
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Affiliation(s)
- Omar Fadili
- Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco.
| | - Abdeljabbar Messoudi
- Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco
| | - Oussama El Adaoui
- Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco
| | - Yassir El Andaloussi
- Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco
| | - Driss Bennouna
- Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco
| | - Mustapha Fadili
- Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco
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Han YS, Yang YF, Chen G, Yu HL, Zhang ZG, Zhou B. Emerging trends and focus of giant cell tumor of bone research from 2001-2021: A visualization research. Front Oncol 2022; 12:1025876. [PMID: 36387182 PMCID: PMC9650254 DOI: 10.3389/fonc.2022.1025876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/11/2022] [Indexed: 09/02/2023] Open
Abstract
UNLABELLED Giant cell tumor of bone is a highly invasive benign tumor with a high postoperative recurrence rate. OBJECTIVE This study aims to analyze the research hotspots and trends of global research on giant cell tumor of bone in the past 20 years, to provide a reference for relevant personnel in this field to carry out academic research. METHODS The literature related to giant cell tumor of bone from 2001 to 2021 was retrieved from the Web of Science. The bibliometrics research method and VOS Viewer were used to extract and analyze the keywords of the journal authors' research institutions, and the research status and development direction in the recent 20 years were visualized. RESULTS A total of 2063 articles were included. The number of global publications is increasing every year. The United States contributes the most to global research, with the most citations and the highest H-index. The journal Clinical Orthopaedics and Related Research published the most articles on this issue. "Denosumab" and "h3f3a" will get more attention and be the next popular hotspot in the future. CONCLUSION The study of giant cell tumor of bone is a hot spot of continuous development and has an important contribution to human health.
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Affiliation(s)
- Ying-Song Han
- Department of Spine Surgery, Xiangtan Central Hospital, Xiangtan, China
| | - Yi-Fan Yang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Gang Chen
- Department of Spine Surgery, Xiangtan Central Hospital, Xiangtan, China
| | - Hai-Liang Yu
- Department of Spine Surgery, Xiangtan Central Hospital, Xiangtan, China
| | - Zhi-Guo Zhang
- Department of Spine Surgery, Xiangtan Central Hospital, Xiangtan, China
| | - Bin Zhou
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
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