Xará-Leite Francisco, Coutinho Luís, Fleming Carolina, Magalhães Manuel, Oliveira Vânia, Rodrigues-Pinto Ricardo, Cardoso Pedro
Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal.
Department of Orthopaedics, Centro Hospitalar Universitário do Porto, Largo do Prof. Abel Salazar, 4099-001, Porto, Portugal.
Eur J Orthop Surg Traumatol. 2020 Jan;30(1):19-23. doi: 10.1007/s00590-019-02554-9. Epub 2019 Sep 16.
Bone giant cell tumors, although benign, may be locally aggressive and cause severe morbidity; in some cases, they can also disseminate at distance and cause death. Denosumab has been approved to treat unresectable bone giant cell tumors or when surgery is likely to result in severe morbidity. Furthermore, its curative potential has been recently suggested.
An 18-year-old girl presented with a spinal giant cell tumor at T9. Neo-adjuvant denosumab was administered for 9 months with great clinical and analytical tolerance. A posterior left T9 costo-transversectomy and vertebral body curettage was performed and the spine stabilized. Interestingly, histopathology examination of the surgical specimens found no evidence of tumoral cells. Denosumab was reinstated until completion of 12 months of treatment.
Denosumab has an important but still limited role in the treatment of spinal giant cell tumors. Here, it resulted in complete histological resolution of the tumor, potentially widening its applicability from a strictly neo-adjuvant to a curative role.
骨巨细胞瘤虽为良性，但可能具有局部侵袭性并导致严重的发病情况；在某些情况下，它们还可能远处转移并导致死亡。地诺单抗已被批准用于治疗不可切除的骨巨细胞瘤或手术可能导致严重发病情况时。此外，最近有人提出其具有治愈潜力。
一名18岁女孩出现T9椎体的脊柱巨细胞瘤。给予新辅助地诺单抗治疗9个月，临床和分析耐受性良好。进行了后路左侧T9肋横突切除术和椎体刮除术，并对脊柱进行了固定。有趣的是，手术标本的组织病理学检查未发现肿瘤细胞的证据。重新给予地诺单抗直至完成12个月的治疗。
地诺单抗在脊柱巨细胞瘤的治疗中具有重要但仍有限的作用。在此病例中，它导致肿瘤在组织学上完全消退，可能将其适用范围从严格的新辅助治疗扩大到治愈性治疗。
