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在使用地诺单抗治疗巨细胞瘤后，对第十一胸椎进行整块全脊椎切除术。

Total en bloc spondylectomy of the eleventh thoracic vertebra following denosumab therapy for the treatment of a giant cell tumor.

作者信息

Inoue Gen, Imura Takayuki, Miyagi Masayuki, Saito Wataru, Tazawa Ryo, Nakazawa Toshiyuki, Takaso Masashi

机构信息

Department of Orthopedic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan.

出版信息

Oncol Lett. 2017 Oct;14(4):4005-4010. doi: 10.3892/ol.2017.6655. Epub 2017 Jul 24.

DOI:10.3892/ol.2017.6655
PMID:28943907
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5592882/
Abstract

Although denosumab has been reported to induce effective clinical results with respect to tumor shrinkage in a short-term follow-up clinical study, total spondylectomy is recognized as the treatment of choice for eradicating giant cell tumors (GCTs) of the spine. The present study reports the case involving a GCT in the 11th thoracic vertebra complicated by idiopathic scoliosis and treated using total en bloc spondylectomy (TES) with preoperative denosumab therapy. A 35-year-old woman received preoperative denosumab therapy for 8 months, followed by surgery using a computed tomography (CT)-based navigation system that optimized accuracy by recognizing the area of the detached parietal pleura, the irregular border of the collapsed vertebra, and the adjacent vertebra. Complete en bloc resection of the vertebra could be performed, suggesting denosumab can be an effective adjuvant therapy which can reduce the complexity of TES and CT-navigation system facilitated the safe use of this surgical method in a patient with idiopathic scoliosis.

摘要

尽管在一项短期随访临床研究中，已报道地诺单抗在肿瘤缩小方面可产生有效的临床效果，但全脊椎切除术被认为是治疗脊柱骨巨细胞瘤（GCT）的首选方法。本研究报告了一例第11胸椎骨巨细胞瘤合并特发性脊柱侧凸的病例，该病例采用术前地诺单抗治疗后行整块全脊椎切除术（TES）。一名35岁女性接受了8个月的术前地诺单抗治疗，随后使用基于计算机断层扫描（CT）的导航系统进行手术，该系统通过识别分离的壁层胸膜区域、塌陷椎体的不规则边界以及相邻椎体来优化准确性。椎体能够被完整整块切除，这表明地诺单抗可以作为一种有效的辅助治疗方法，它能够降低TES的复杂性，并且CT导航系统有助于在患有特发性脊柱侧凸的患者中安全使用这种手术方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/5747709f4890/ol-14-04-4005-g08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/d1233372b260/ol-14-04-4005-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/9952486bf07e/ol-14-04-4005-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/d46941386c9e/ol-14-04-4005-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/87ae9a7ec0c6/ol-14-04-4005-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/c3c4871d486c/ol-14-04-4005-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/8a45caa7ec7f/ol-14-04-4005-g05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/33510ac89820/ol-14-04-4005-g06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/5112f53d39f3/ol-14-04-4005-g07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/5747709f4890/ol-14-04-4005-g08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/d1233372b260/ol-14-04-4005-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/9952486bf07e/ol-14-04-4005-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/d46941386c9e/ol-14-04-4005-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/87ae9a7ec0c6/ol-14-04-4005-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/c3c4871d486c/ol-14-04-4005-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/8a45caa7ec7f/ol-14-04-4005-g05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/33510ac89820/ol-14-04-4005-g06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/5112f53d39f3/ol-14-04-4005-g07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb3/5592882/5747709f4890/ol-14-04-4005-g08.jpg

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