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Simran, Nanda S, Meher P, M Rath S, Gupta RK, Galeti R. Recurrent Giant Cell Tumor of Sphenoid Bone: A Rare Finding. Indian J Otolaryngol Head Neck Surg 2024; 76:2134-2136. [PMID: 38566643 PMCID: PMC10982203 DOI: 10.1007/s12070-023-04464-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/21/2023] [Indexed: 04/04/2024] Open
Abstract
Giant Cell Tumors of the skull are rare and mostly occur in the middle cranial fossa. Radiological investigations serve as adjunct modalities; however, histopathological confirmation is mandatory. Ten to forty% of GCTs may be recurrent. Complete surgical resection is the treatment of choice, however, partial resection with adjuvant radiotherapy can serve as a secondary alternative. Recurrent cases require post-op radiotherapy. Here, we describe a case of recurrent giant cell tumor of sphenoid bone in a young male, who underwent surgical resection twice, after which he was advised adjuvant radiotherapy and denosumab. The patient did not take radiotherapy.
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Affiliation(s)
- Simran
- Department of Radiation Oncology, AIIMS Raipur, Raipur, Chattisgarh India
| | - Siddhartha Nanda
- Department of Radiation Oncology, AIIMS Raipur, Raipur, Chattisgarh India
| | - Papuji Meher
- Department of Radiation Oncology, AIIMS Raipur, Raipur, Chattisgarh India
| | - Swaroopa M Rath
- Department of Radiation Oncology, AIIMS Raipur, Raipur, Chattisgarh India
| | - Rakesh Kumar Gupta
- Department of Pathology and Lab Medicine, AIIMS Raipur, Raipur, Chattisgarh India
| | - Revathi Galeti
- Department of Pathology and Lab Medicine, AIIMS Raipur, Raipur, Chattisgarh India
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2
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Amoodi H, Al-Domaidat D, Danish A, Alshaikh Hasan R. Giant Cell Tumor of the Temporal Bone and Skull Base. J Craniofac Surg 2023; 34:e628-e630. [PMID: 37236622 DOI: 10.1097/scs.0000000000009432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/10/2023] [Indexed: 05/28/2023] Open
Abstract
Giant cell tumor (GCT) is a benign tumor that originates from undifferentiated mesenchymal cells of the bone marrow. The craniums as well as temporal bone are extremely rare locations for GCTs. Clinical, radiological, and anatomical diagnosis of this locally aggressive disease poses a major challenge in clinical practice. In this article, we present a clinical study for a 35-year-old female who was found to have left-sided temporal bone GCT with extension to middle cranial fossa and temporomandibular joint (TMJ) with its clinical features and management.
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Affiliation(s)
- Hosam Amoodi
- Otolaryngology Department, Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
- Department of Surgery, Jeddah University, Jeddah, Saudi Arabia
| | - Derar Al-Domaidat
- Otolaryngology Department, Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
| | | | - Ro'a Alshaikh Hasan
- Internal Medicine Department, Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
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3
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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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4
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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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5
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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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6
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Kaya İ, Benzer M, Turhal G, Sercan G, Bilgen C, Kirazlı T. Giant Cell Tumor of the Temporal Bone and Skull Base: A Case Report. J Int Adv Otol 2019; 14:151-154. [PMID: 29764791 DOI: 10.5152/iao.2018.3609] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Giant cell tumor (GCT) is a benign tumor that originates from undifferentiated mesenchymal cells of the bone marrow. The cranium as well as temporal bone is a rare location for GCTs. Despite its benign nature, GCT may be locally aggressive and has the potential to recur locally. Furthermore, GCT may give rise to pulmonary metastases (~1%) in addition to causing local bone destruction. Surgical excision is the treatment of choice for patients with GCT. We describe the case of a 56-year-old female who presented with headache and hearing loss with extensive GCT, which originated in the squamous part of the temporal bone and extended into the left mandibular fossa and middle ear. She was treated by total resection of the tumor using left temporal craniotomy approach. In this article, we present a case of temporal bone GCT with its clinical features as well as a review of the related literature.
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Affiliation(s)
- İsa Kaya
- Department of Otolaryngology, Ege University School of Medicine, Izmir, Turkey
| | - Murat Benzer
- Department of Otolaryngology, Ege University School of Medicine, Izmir, Turkey
| | - Göksel Turhal
- Clinic of Otolaryngology, Selcuk State Hospital, Izmir, Turkey
| | - Gode Sercan
- Department of Otolaryngology, Ege University School of Medicine, Izmir, Turkey
| | - Cem Bilgen
- Department of Otolaryngology, Ege University School of Medicine, Izmir, Turkey
| | - Tayfun Kirazlı
- Department of Otolaryngology, Ege University School of Medicine, Izmir, Turkey
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7
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Weng JC, Li D, Wang L, Wu Z, Wang JM, Li GL, Jia W, Zhang LW, Zhang JT. Surgical management and long-term outcomes of intracranial giant cell tumors: a single-institution experience with a systematic review. J Neurosurg 2018; 131:695-705. [PMID: 30497189 DOI: 10.3171/2018.4.jns1849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/23/2018] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Intracranial giant cell tumors (GCTs) are extremely rare neoplasms with dismal survival and recurrence rates. The authors aimed to confirm independent adverse factors for progression-free survival (PFS) and to propose an optimal treatment algorithm. METHODS The authors reviewed the clinical data of 43 cases of intracranial GCTs in their series. They also reviewed 90 cases of previously reported GCTs in the English language between 1982 and 2017 using Ovid MEDLINE, Embase, PubMed, and Cochrane databases with keywords of "giant cell tumor" or "osteoclastoma" and "skull," "skull base," "temporal," "frontal," "sphenoid," or "occipital." These prior publication data were processed and used according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Aforementioned risk factors for the authors' series and the pooled cases were evaluated in patients not lost to follow-up (m = 38 and n = 128, respectively). RESULTS The authors' cohort included 28 males and 15 females with a mean age of 30.5 years. Gross-total resection (GTR) was achieved in 15 (34.9%) patients. Fifteen patients (39.5%) who did not undergo GTR received postoperative radiotherapy with a mean total dose of 54.7 ± 4.1 Gy. After a mean follow-up of 71.3 months, 12 (31.6%) patients experienced recurrence, and 4 (10.5%) died of disease. The actuarial 5-year PFS and overall survival (OS) were 68.6% and 90.0% in the authors' cohort, respectively. A multivariate Cox regression analysis verified that partial resection (HR 7.909, 95% CI 2.296-27.247, p = 0.001), no radiotherapy (HR 0.114, 95% CI 0.023-0.568, p = 0.008), and Ki-67 ≥ 10% (HR 7.816, 95% CI 1.584-38.575, p = 0.012) were independent adverse factors for PFS. Among the 90 cases in the literature, GTR was achieved in 49 (54.4%) cases. Radiotherapy was administered to 33 (36.7%) patients with a mean total dose of 47.1 ± 5.6 Gy. After a mean follow-up of 31.5 months, recurrence and death occurred in 17 (18.9%) and 5 (5.6%) cases, respectively. Among the pooled cases, the 5-year PFS and OS were 69.6% and 89.2%, respectively. A multivariate model demonstrated that partial resection (HR 4.792, 95% CI 2.909-7.893, p < 0.001) and no radiotherapy (HR 0.165, 95% CI 0.065-0.423, p < 0.001) were independent adverse factors for poor PFS. CONCLUSIONS GTR and radiotherapy were independent favorable factors for PFS of intracranial GCTs. Based on these findings, GTR alone or GTR plus radiotherapy was advocated as an optimal treatment; otherwise, partial resection plus radiotherapy with a dose ≥ 45 Gy, if tolerable, was a secondary alternative. Lack of randomized data of the study was stressed, and future studies with larger cohorts are necessary to verify these findings.Systematic review no.: CRD42018090878 (crd.york.ac.uk/PROSPERO/).
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Affiliation(s)
- Jian-Cong Weng
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
| | - Da Li
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
| | - Liang Wang
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
| | - Zhen Wu
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
| | - Jun-Mei Wang
- 2Department of Neuropathology, Beijing Neurosurgical Institute, Beijing, People's Republic of China
| | - Gui-Lin Li
- 2Department of Neuropathology, Beijing Neurosurgical Institute, Beijing, People's Republic of China
| | - Wang Jia
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
| | - Li-Wei Zhang
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
| | - Jun-Ting Zhang
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
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8
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Gamboa NT, Ronna B, Gamboa CT, Palmer CA, Park MS, Gurgel RK, Couldwell WT, Kalani MYS. Giant Cell Tumor of the Lateral Skull Base: Diagnostic and Management Options. J Neurol Surg Rep 2018; 79:e41-e54. [PMID: 29845001 PMCID: PMC5969995 DOI: 10.1055/s-0038-1645885] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 02/27/2018] [Indexed: 01/02/2023] Open
Abstract
Giant cell tumor of bone (GCTB) is a rare, benign, osteolytic neoplasm that most commonly occurs in early adulthood and often involves the long bones of the body. Although GCTB largely affects the epiphyses of long bones, several reports of GCTB involvement of the cranial and facial bones exist in the literature. In addition to reviewing other reported cases of GCTBs of the lateral skull base in the literature, the authors report here on the clinical presentation, radiographic findings, and neurosurgical management of a patient found to have a GCTB of the middle and infratemporal fossae, which was treated by aggressive en bloc resection of the lateral skull base.
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Affiliation(s)
- Nicholas T Gamboa
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Brenden Ronna
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Christina T Gamboa
- Department of Radiation Oncology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
| | - Cheryl A Palmer
- Division of Anatomic Pathology, Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Min S Park
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Richard K Gurgel
- Division of Otolaryngology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - William T Couldwell
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - M Yashar S Kalani
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah School of Medicine, Salt Lake City, Utah, United States
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9
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Scotto di Carlo F, Divisato G, Iacoangeli M, Esposito T, Gianfrancesco F. The identification of H3F3A mutation in giant cell tumour of the clivus and the histological diagnostic algorithm of other clival lesions permit the differential diagnosis in this location. BMC Cancer 2018; 18:358. [PMID: 29609578 PMCID: PMC5880014 DOI: 10.1186/s12885-018-4291-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Giant Cell Tumour of Bone (GCT) is a locally aggressive primary bone tumour that usually occurs at the epiphyses of the long bones of the appendicular skeleton with a tendency to recurrence. Recurrent somatic H3F3A mutations have been described in 92% of GCT cases. GCTs involving the Clivus are extremely rare lesions and less than 15 cases are described in the literature. They represent a surgery challenge and are easily misdiagnosed. Our aim was to reveal if the genetic bases underlying Clival GCTs were the same of GCTs of long bones to improve the diagnosis and treatment. METHODS The targeted somatic sequencing of GCT-related genes (H3F3A, H3F3B, IDH1, IDH2 and ZNF687) was performed on Clival GCT biopsies of two different cases. Histological analyses on the same tissues were used to detect the neoplastic population and its expression profile. RESULTS Sanger sequencing revealed that both patients were positive for the p.Gly34Trp mutation in the H3F3A gene. Immunofluorescence assay using monoclonal antibody, specifically detecting the mutant H3.3, highlighted that the mutation only involved the mononuclear cell population and not the multinucleated giant cells. Moreover, immunohistochemistry assay showed that RANKL was highly expressed by the stromal cells within Clival GCT, mimicking what happens in GCT of the long bones. In addition, systematic literature review allowed us to generate a histology-based diagnostic algorithm of the most common clival lesions. CONCLUSIONS We conclude that the Clival GCT is genetically defined by somatic mutation in the H3F3A gene, linking it to the GCT of long bones. The similarity with GCTs of long bones let us to hypothesize the utility of Denosumab therapy (already effective for GCTs) in these surgically challenging cases. Moreover, H3F3A genetic screening can be combined to the histological analysis to differentiate GCTs from morphologically similar giant cell-rich sarcomas, while the histological diagnostic algorithm could help the differential diagnosis of other clival lesions.
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Affiliation(s)
- Federica Scotto di Carlo
- Institute of Genetics and Biophysics "Adriano Buzzati-Traverso", National Research Council of Italy, Naples, Italy.,Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DiSTABiF), University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Giuseppina Divisato
- Institute of Genetics and Biophysics "Adriano Buzzati-Traverso", National Research Council of Italy, Naples, Italy
| | | | - Teresa Esposito
- Institute of Genetics and Biophysics "Adriano Buzzati-Traverso", National Research Council of Italy, Naples, Italy.,IRCCS INM Neuromed, Pozzilli, Italy
| | - Fernando Gianfrancesco
- Institute of Genetics and Biophysics "Adriano Buzzati-Traverso", National Research Council of Italy, Naples, Italy.
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10
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de la Peña C, Guajardo JH, Gonzalez MF, Hinojosa MA, Cardona E. Cyberknife stereotactic radiosurgery and denosumab for giant cell tumour of the skull base: Case report. Rep Pract Oncol Radiother 2017; 22:429-433. [PMID: 28883763 DOI: 10.1016/j.rpor.2017.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 02/16/2017] [Accepted: 08/03/2017] [Indexed: 10/19/2022] Open
Abstract
Giant cell tumours (GCT) of the skull is a rare entity with only small number of cases reported in literature and optimal treatment is yet to be determined. These tumours have shown high recurrence rates after incomplete surgery, usually occurring during the first year. Even with new surgical techniques a complete resection in skull base tumours is not always possible without functional compromise. Therefore, adjuvant therapy is essential to enhance local control and quality of life. We report a rare case of a 34-year-old male with giant cell tumour (GCT) of the skull base involving the petrous bone, clivus and sphenoid body. The patient received Cyberknife stereotactic radiosurgery (CK SRS) and denosumab after surgery. This combined therapy allowed local control and tumour reduction with secondary neurological improvement during a 4-year follow up.
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Affiliation(s)
- Cuauhtemoc de la Peña
- Department of Radiosurgery, Neuro-Oncology Unit, Hospital de Alta Especialidad Chistrus Muguerza, Monterrey, Nuevo León, Mexico
| | - Jorge H Guajardo
- Department of Neurosurgery, Neuro-Oncology Unit, Hospital de Alta Especialidad Chistrus Muguerza, Monterrey, Nuevo León, Mexico
| | - Maria F Gonzalez
- Department of Neuro-oncology, Neuro-Oncology Unit, Hospital de Alta Especialidad Chistrus Muguerza, Monterrey, Nuevo León, Mexico
| | - Miguel A Hinojosa
- Department of Physics, Neuro-Oncology Unit, Hospital de Alta Especialidad Chistrus Muguerza, Monterrey, Nuevo León, Mexico
| | - Erick Cardona
- Department of Physics, Neuro-Oncology Unit, Hospital de Alta Especialidad Chistrus Muguerza, Monterrey, Nuevo León, Mexico
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11
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Bardakhchyan S, Kager L, Danielyan S, Avagyan A, Karamyan N, Vardevanyan H, Mkhitaryan S, Papyan R, Zohrabyan D, Safaryan L, Sargsyan L, Harutyunyan L, Hakobyan L, Iskanyan S, Tamamyan G. Denosumab treatment for progressive skull base giant cell tumor of bone in a 14 year old female - a case report and literature review. Ital J Pediatr 2017; 43:32. [PMID: 28356124 PMCID: PMC5372271 DOI: 10.1186/s13052-017-0353-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 03/27/2017] [Indexed: 02/06/2023] Open
Abstract
Background Giant cell tumor of bone (GCT) is a rare primary bone tumor, which can metastasize and undergo malignant transformation. The standard treatment of GCT is surgery. In patients with unresectable or metastatic disease, additional therapeutic options are available. These include blocking of the receptor activator of NF-kappa B ligand (RANKL) signaling pathway, which plays a role in the pathogenesis of GCT of bone, via the anti-RANKL monoclonal antibody denosumab. Case Presentation Herein we report on a female teenager who presented in a very poor clinical condition (cachexia, diplopia, strabismus, dysphonia with palsy of cranial nerves V, VI, VIII, IX, X, XI and XII) due to progressive disease, after incomplete resection and adjuvant radiotherapy, of a GCT which affected the cervical spine (C1 and C2) as well as the skull base; and who had an impressive clinical response to denosumab therapy. To the best of our knowledge, this is the youngest patient ever reported with a skull base tumor treated with denosumab. Conclusion In situations when surgery can be postponed and local aggressiveness of the tumor does not urge for acute surgical intervention, upfront use of denosumab in order to reduce the tumor size might be considered. Principally, the goal of denosumab therapy is to reduce tumor size as much as possible, with the ultimate goal to make local surgery (or as in our case re-surgery) amenable. However, improvement in quality of life, as demonstrated in our patient, is also an important aspect of such targeted therapies. Electronic supplementary material The online version of this article (doi:10.1186/s13052-017-0353-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Samvel Bardakhchyan
- Department of Oncology, Yerevan State Medical University, Yerevan, Armenia.,Yerevan State Medical University, Muratsan Hospital Complex, Clinic of Chemotherapy, Yerevan, Armenia.,Armenian Pediatric Hematology and Oncology Group, Yerevan, Armenia
| | - Leo Kager
- Department of Pediatrics, St. Anna Children's Hospital, Medical University Vienna, Vienna, Austria.,Children's Cancer Research Institute (CCRI), Vienna, Austria
| | - Samvel Danielyan
- Department of Oncology, Yerevan State Medical University, Yerevan, Armenia.,Yerevan State Medical University, Muratsan Hospital Complex, Clinic of Chemotherapy, Yerevan, Armenia.,Armenian Pediatric Hematology and Oncology Group, Yerevan, Armenia
| | - Armen Avagyan
- Yerevan State Medical University, Muratsan Hospital Complex, Clinic of Chemotherapy, Yerevan, Armenia.,Armenian Pediatric Hematology and Oncology Group, Yerevan, Armenia
| | - Nerses Karamyan
- Department of Oncology, Yerevan State Medical University, Yerevan, Armenia.,Department of Radiotherapy, National Center of Oncology, Yerevan, Armenia
| | - Hovhannes Vardevanyan
- Armenian Pediatric Hematology and Oncology Group, Yerevan, Armenia.,Department of Radiology, Armenian-American Wellness Center, Yerevan, Armenia
| | - Sergey Mkhitaryan
- Department of Oncology, Yerevan State Medical University, Yerevan, Armenia.,Yerevan State Medical University, Muratsan Hospital Complex, Clinic of Chemotherapy, Yerevan, Armenia.,Armenian Pediatric Hematology and Oncology Group, Yerevan, Armenia
| | - Ruzanna Papyan
- Department of Oncology, Yerevan State Medical University, Yerevan, Armenia.,Yerevan State Medical University, Muratsan Hospital Complex, Clinic of Chemotherapy, Yerevan, Armenia.,Armenian Pediatric Hematology and Oncology Group, Yerevan, Armenia
| | - Davit Zohrabyan
- Department of Oncology, Yerevan State Medical University, Yerevan, Armenia.,Yerevan State Medical University, Muratsan Hospital Complex, Clinic of Chemotherapy, Yerevan, Armenia.,Armenian Pediatric Hematology and Oncology Group, Yerevan, Armenia
| | - Liana Safaryan
- Department of Oncology, Yerevan State Medical University, Yerevan, Armenia.,Yerevan State Medical University, Muratsan Hospital Complex, Clinic of Chemotherapy, Yerevan, Armenia.,Armenian Pediatric Hematology and Oncology Group, Yerevan, Armenia
| | - Lilit Sargsyan
- Department of Oncology, Yerevan State Medical University, Yerevan, Armenia.,Yerevan State Medical University, Muratsan Hospital Complex, Clinic of Chemotherapy, Yerevan, Armenia.,Armenian Pediatric Hematology and Oncology Group, Yerevan, Armenia
| | - Lilit Harutyunyan
- Yerevan State Medical University, Muratsan Hospital Complex, Clinic of Chemotherapy, Yerevan, Armenia.,Armenian Pediatric Hematology and Oncology Group, Yerevan, Armenia
| | - Lusine Hakobyan
- Department of Oncology, Yerevan State Medical University, Yerevan, Armenia.,Yerevan State Medical University, Muratsan Hospital Complex, Clinic of Chemotherapy, Yerevan, Armenia.,Armenian Pediatric Hematology and Oncology Group, Yerevan, Armenia
| | - Samvel Iskanyan
- Yerevan State Medical University, Muratsan Hospital Complex, Clinic of Chemotherapy, Yerevan, Armenia.,Armenian Pediatric Hematology and Oncology Group, Yerevan, Armenia
| | - Gevorg Tamamyan
- Department of Oncology, Yerevan State Medical University, Yerevan, Armenia. .,Yerevan State Medical University, Muratsan Hospital Complex, Clinic of Chemotherapy, Yerevan, Armenia. .,Armenian Pediatric Hematology and Oncology Group, Yerevan, Armenia.
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Nicoli TK, Saat R, Kontio R, Piippo A, Tarkkanen M, Tarkkanen J, Jero J. Multidisciplinary Approach to Management of Temporal Bone Giant Cell Tumor. J Neurol Surg Rep 2017; 77:e144-e149. [PMID: 28078198 PMCID: PMC5045306 DOI: 10.1055/s-0036-1592082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Giant cell tumors (GCTs) are rare osseous tumors that rarely appear in
the skull. Methods We review the clinical course of a 28-year-old previously healthy woman
with a complicated GCT. Results The reviewed patient presented with a middle cranial fossa tumor acutely
complicated by reactive mastoiditis. Left tympanomastoidectomy was performed for
drainage of the mastoiditis and for biopsies of the tumor. Due to the challenging tumor
location, the patient was treated with denosumab, a fully humanized monoclonal antibody
against receptor activator of nuclear factor kappa-B ligand, for 7 months, which
resulted in significant preoperative tumor shrinkage. Extensive temporal craniotomy and
resection of the tumor followed utilizing a temporomandibular joint total endoprosthesis
for reconstruction. A recurrence of the tumor was detected on computed tomography at 19
months after surgery and treated with transtemporal tumor resection, parotidectomy, and
mandible re-reconstruction. Conclusion A multidisciplinary approach resulted in a good functional result and,
finally, an eradication of the challengingly located middle cranial fossa tumor.
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Affiliation(s)
- Taija K Nicoli
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Riste Saat
- Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Risto Kontio
- Department of Maxillofacial Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anna Piippo
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki Finland
| | - Maija Tarkkanen
- Cancer Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jussi Tarkkanen
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jussi Jero
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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