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Gupta A, Colwell B, Clarke DB, Massoud EA, Croul S, Hussain A. The Role of Denosumab Treatment in Recurrent Giant Cell Bone Tumor of the Orbit. Ophthalmic Plast Reconstr Surg 2024:00002341-990000000-00420. [PMID: 38984651 DOI: 10.1097/iop.0000000000002672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
Giant cell tumor of the bone (GCTB) is a rare primary bone neoplasm, representing about 5% of all primary bone tumors. Most GCTBs are found in the epiphysis of long bones, with only 2% of GCTBs involving the skull. In recent years, the receptor activator of nuclear factor Kappa ligand monoclonal antibody denosumab has been demonstrated as a promising therapeutic option for GCTB; however, this is an evolving field. We present a case of a 57-year-old female with a rare GCTB in the right orbit and sinuses, originally thought to be an aneurysmal bone cyst. Her symptoms included proptosis, intermittent blurry vision, sinus congestion, and frontal headaches. After excision, the tumor recurred within 18 months. Upon repeat excision, a diagnosis of GCTB was made. The patient started denosumab therapy and had no tumor growth over the ensuing 2 years, with stability of symptoms and clinical signs on follow-up.
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Affiliation(s)
- Arjav Gupta
- Northern Ontario School of Medicine University, Thunder Bay, Ontario
| | - Bruce Colwell
- Division of Medical Oncology, Department of Medicine
| | | | - Emad A Massoud
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery
| | | | - Ahsen Hussain
- Department of Ophthalmology & Vision Science, Dalhousie University, Halifax, Nova Scotia, Canada
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Gersey ZC, Zenonos GA, Gardner PA. Malignant Brain and Spinal Tumors Originating from Bone or Cartilage. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1405:477-506. [PMID: 37452950 DOI: 10.1007/978-3-031-23705-8_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Malignant bone tumors affecting the brain and spine are a rare and exceedingly difficult-to-treat group of diseases. Most commonly consisting of chordoma and chondrosarcoma, these tumors also include giant-cell tumors and osteosarcomas. This chapter will cover the background, epidemiology, genetics, molecular biology, histopathology, radiographic features, clinical manifestations, therapeutic approaches, and clinical management of each entity.
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Affiliation(s)
- Zachary C Gersey
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Georgios A Zenonos
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Paul A Gardner
- UPMC Center for Cranial Base Surgery, 200 Lothrop Street, PUH B-400, Pittsburgh, PA, 15213, USA.
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Hu S, Cheng S, Wu Y, Wang Y, Li X, Zheng J, Li J, Peng L, Yang J. A Large Cavernous Sinus Giant Cell Tumor Invading Clivus and Sphenoid Sinus Masquerading as Meningioma: A Case Report and Literature Review. Front Surg 2022; 9:861739. [PMID: 35402500 PMCID: PMC8991686 DOI: 10.3389/fsurg.2022.861739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/11/2022] [Indexed: 12/01/2022] Open
Abstract
Giant cell tumor (GCT) of the bone is a rare benign, locally aggressive tumor that occurs in the epiphysis of long bones, especially the lower femur and the upper tibia. GCT of the bone of cranial origin is very rare, accounting for 1% of all GCT of the bone. We report the diagnosis, treatment, and immunohistochemistry of a rare case of intracranial GCT of the bone. We also review and summarize the imaging features, diagnostic markers, and current major treatment options for GCT of the bone. Our case and literature review emphasizes the importance of considering the full picture when making a diagnosis, rather than relying on imaging alone to make the diagnosis.
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Affiliation(s)
- Shasha Hu
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Shaowen Cheng
- Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China.,Department of Wound Repair, First Affiliated Hospital of Hainan Medical University, Haikou, China.,Key Laboratory of Emergency and Trauma Ministry of Education, Hainan Medical University, Haikou, China
| | - Yu Wu
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Yanyan Wang
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - XinNian Li
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Jiaxuan Zheng
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Jiao Li
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Lei Peng
- Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China.,Key Laboratory of Emergency and Trauma Ministry of Education, Hainan Medical University, Haikou, China
| | - Jian Yang
- Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China.,Department of Wound Repair, First Affiliated Hospital of Hainan Medical University, Haikou, China.,Key Laboratory of Emergency and Trauma Ministry of Education, Hainan Medical University, Haikou, China
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Yaprak Bayrak B, Özcan E, Vural Ç, Emengen A, Çabuk B, Ceylan S. A single-center experience with giant cell tumors of sphenoid bone and clivus. TUMORI JOURNAL 2021; 107:NP94-NP100. [PMID: 34374310 DOI: 10.1177/03008916211024357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To present pathologic, clinical, and treatment findings for giant cell tumors (GCTs) of sphenoid bone and clivus. METHODS We describe the optimal treatment algorithm in patients with a histopathologic diagnosis of bone GCT by presenting the effects of denosumab treatment in both pediatric and adult patients with GCT undergoing endoscopic transnasal surgery. Clinicopathologic correlation is crucial for the differential diagnosis of GCT and the choice of treatment modality. CONCLUSION GCT of bone is a local aggressive tumor that accounts for about 3%-7% of all bone tumors. GCTs located in the cranium are extremely uncommon neoplasms. There are no defined guidelines for the treatment of GCTs in skull base. Following surgical resection of the tumor, the addition of denosumab treatments to radiotherapy has a significant role in preventing the recurrence of GCT and in promoting regression of residual tumor size.
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Affiliation(s)
- Büşra Yaprak Bayrak
- Department of Pathology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Emre Özcan
- Department of Pathology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Çiğdem Vural
- Department of Pathology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Atakan Emengen
- Department of Neurosurgery, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Burak Çabuk
- Department of Neurosurgery, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Savaş Ceylan
- Department of Neurosurgery, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
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Kadipasaoglu C, Wahba A, Bhattacharjee MB, Cuglievan B, Fletcher SA. Hemorrhagic Giant Cell Tumor of the Occipital Skull Base: A Case Report and Literature Review. Cureus 2021; 13:e13832. [PMID: 33859893 PMCID: PMC8038930 DOI: 10.7759/cureus.13832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Giant cell tumor of bone is a benign but locally aggressive osteolytic neoplasm that represents 3% to 5% of all primary bone tumors, primarily found at the epiphyses of long bones. Less than 1% are of calvarial origin. Herein, we report a rare case of a nine-year-old girl with a hemorrhagic giant cell tumor of the left occipital skull base.
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Affiliation(s)
- Cihan Kadipasaoglu
- Department of Pediatric Surgery, Division of Pediatric Neurosurgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, USA
| | - Andrew Wahba
- Division of Pediatrics and Patient Care, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Meenakshi B Bhattacharjee
- Department of Neuropathology, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, USA
| | - Branko Cuglievan
- Division of Pediatrics and Patient Care, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Stephen A Fletcher
- Department of Pediatric Surgery, Division of Pediatric Neurosurgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, USA
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Tanikawa M, Yamada H, Sakata T, Mase M. Dosing interval adjustment of denosumab for the treatment of giant cell tumor of the sphenoid bone: A case report. Surg Neurol Int 2021; 11:370. [PMID: 33408904 PMCID: PMC7771493 DOI: 10.25259/sni_439_2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/06/2020] [Indexed: 01/17/2023] Open
Abstract
Background: In the treatment of giant cell tumor of bone (GCTB), the efficacy and safety of denosumab, a receptor activator nuclear factor κ-B ligand inhibitor, has previously been demonstrated, especially for unresectable tumors. One of the current issues in denosumab treatment for unresectable GCTB is whether it can be discontinued, or whether the dosage or the dosing interval can safely be adjusted, if discontinuation is not possible, to avoid the occurrence of side effects. Case Description: A 15-year-old boy with diplopia was referred to our hospital after a space-occupying lesion in the sphenoid bone was found on head CT. Partial removal of the tumor was performed through an endoscopic endonasal approach, and pathological diagnosis was confirmed as GCTB. Thereafter, the patient received 120 mg subcutaneous injections of denosumab every 28 days for the first 2 years. Since bone formation was induced and sustained along with tumor reduction, the dosing interval was gradually extended, with 4 monthly dosing for the next 1 year, followed by 6 monthly dosing for the succeeding 2 years. With the extension of the dosing interval, the ossified tumor has regrown slightly, but within an acceptable range. Conclusion: Discontinuation of denosumab treatment for unresectable GCTB was not thought to be possible for the current case due to the nature of the drug, as reported in the literature. Extending the dosing interval up to 6 monthly, as could be done safely in the current case, can be considered a useful and appropriate measure.
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Affiliation(s)
- Motoki Tanikawa
- Department of Neurosurgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho, Nagoya, Aichi, Japan
| | - Hiroshi Yamada
- Department of Neurosurgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho, Nagoya, Aichi, Japan
| | - Tomohiro Sakata
- Department of Neurosurgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho, Nagoya, Aichi, Japan
| | - Mitsuhito Mase
- Department of Neurosurgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho, Nagoya, Aichi, Japan
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Rajabi MT, Poursayed Lazarjani SZ, Mohammadi SS, Veshagh M, Hosseinzadeh F, Rafizadeh SM, Amoli FA, Hosseini S. Giant Cell Tumor: Changing Behavior from Intraorbital to Intraosseous Mass. J Curr Ophthalmol 2020; 32:414-416. [PMID: 33553846 PMCID: PMC7861103 DOI: 10.4103/joco.joco_63_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 03/13/2020] [Accepted: 03/29/2020] [Indexed: 11/04/2022] Open
Abstract
Purpose To present a patient with giant cell tumor (GCT) of the orbit by changing behavior from an intraorbital mass to an intraosseous tumor. Methods A 16-year-old boy presented with pain, swelling, erythematous of the left upper and lower eyelids, proptosis, and diplopia. Ophthalmic examination revealed chemosis, conjunctival injection, limited elevation, depression as well as abduction in the left eye. Results Multislice computed tomography scan (CT scan) of the orbit and paranasal sinuses showed a hyperdense, oval, extraconal mass with bone erosion. Magnetic resonance imaging of the orbit showed an inferior lateral isointense, oval, extraconal mass that had indented the globe. The patient underwent superior lateral orbitotomy, and the orbital mass was excised. Two months later, the patient developed proptosis, severe chemosis, and eyelid erythema in the same eye. CT scan showed an intraosseous mass in the lateral wall of the orbit that had pushed the globe anteromedially. Intraosseous tumor was resected, and the lateral orbital wall was drilled during the second surgery. GCT was diagnosed based on pathological survey. Conclusion Following the resection of the orbital GCT, the tumor behavior may change to an intraosseous lesion.
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Affiliation(s)
- Mohammad Taher Rajabi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - S Saeed Mohammadi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Veshagh
- Eye Research Center, Labbafinejad Eye Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farideh Hosseinzadeh
- ENT and Head and Neck Research Center, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohsen Rafizadeh
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Asadi Amoli
- Department of Pathology, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Simindokht Hosseini
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
The aim of the study is to discuss the current management options for intra- and extra-cranial communication giant cell tumor of the lateral skull base and perform a review of the literature. A total of 6 patients with giant cell tumor of the lateral skull base were retrospectively enrolled in the study. The principal complaints, imaging manifestations, surgical resection and reconstruction of intra- and extra-cranial communication defects for the diseases were discussed. There were 2 males and 4 females. The most of principal complaints were discomfort or pain in the temporomandibular joint in 5 cases (83.3%). Imaging examination showed invasion of the temporal bone alone in 3 cases (50.0%) and both temporal bone and sphenoid bone involvement in 3 cases (50.0%). C-shaped preauricular infratemporal fossa approach was used for tumour removal and gross total resection was done in all 6 cases. The pedicled temporal muscle fascial flap was used to reconstruct the intra- and extra-cranial communication defect of the lateral skull base. The conclusion is that giant cell tumor is a benign tumor but is also locally aggressive. Gross total resection is the most commonly recommended treatment choice for giant cell tumor of the skull and can achieve good treatment outcomes. The temporalis muscle flap is a good alternative choice for reconstruction of the defect.
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