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Matcuk GR, Waldman LE, Fields BKK, Colangeli M, Palmas M, Righi A, Filonzi G, Crombé A, Spinnato P. Conventional radiography for the assessment of focal bone lesions of the appendicular skeleton: fundamental concepts in the modern imaging era. Skeletal Radiol 2025; 54:1391-1406. [PMID: 39718620 PMCID: PMC12078366 DOI: 10.1007/s00256-024-04854-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2024] [Revised: 12/03/2024] [Accepted: 12/04/2024] [Indexed: 12/25/2024]
Abstract
Bone lesions of the appendicular skeleton can be caused by primary benign or malignant tumors, metastases, osteomyelitis, or pseudotumors. Conventional radiography plays a crucial role in the initial assessment of osseous lesions and should not be underestimated even in this era of modern complex and advanced imaging technologies. Combined with patient age, clinical symptoms and biology, and lesion features including location, solitary versus multiplicity, density, margin (transitional zone evaluated with Lodwick-Madewell grading score), and, if present, the type of periosteal reaction and matrix mineralization can narrow the differential diagnosis or offer a likely diagnosis. These radiographic features help guide further follow-up or management.
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Affiliation(s)
- George R Matcuk
- Department of Imaging, S. Mark Taper Foundation Imaging Center, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Ste M-335, Los Angeles, CA, 90048, USA.
| | - Leah E Waldman
- Department of Radiology, Duke University School of Medicine, Durham, NC, 27705, USA
| | - Brandon K K Fields
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, 94143, USA
| | - Marco Colangeli
- Orthopaedic Oncology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136, Bologna, Italy
| | - Marco Palmas
- Orthopaedic Oncology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136, Bologna, Italy
| | - Alberto Righi
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, 40136, Bologna, Italy
| | - Giacomo Filonzi
- Department of Radiology, Ospedale Maggiore, 40133, Bologna, Italy
| | - Amandine Crombé
- Department of Musculoskeletal Radiology, Pellegrin Hospital, Bordeaux University, F-33000, Bordeaux, France
| | - Paolo Spinnato
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, 40136, Bologna, Italy
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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 2025; 54:1323-1330. [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] [MESH Headings] [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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Dharmashaktu Y, Shamim SA, Rastogi S, Wakankar R, Barwad A. 18F-FDG PET/CT in a Giant Cell Tumor of Bone Masquerading as a Retroperitoneal Soft Tissue Sarcoma. Clin Nucl Med 2025:00003072-990000000-01734. [PMID: 40392137 DOI: 10.1097/rlu.0000000000005981] [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: 02/18/2025] [Accepted: 04/20/2025] [Indexed: 05/22/2025]
Abstract
Giant cell tumor of bone (GCTB) is a rare, benign but locally aggressive neoplasm that typically arises in the epiphysis of long bones. GCTB occurrence in the axial skeleton is less common. Due to its variable radiological appearance and unusual location, GCTB can be misdiagnosed as a soft tissue or retroperitoneal mass, leading to delays in diagnosis and inappropriate treatment. We present the case of a 36-year-old woman who was misdiagnosed as a case of spinal tuberculosis and was started on ATT. Initial imaging, including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), revealed a large, retroperitoneal mass involving the L2 vertebral body, raising suspicion of a malignant soft tissue tumor. Further evaluation with 18F-FDG PET/CT suggested a retroperitoneal metabolically active lesion, reinforcing the need for histopathological confirmation.
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Affiliation(s)
| | | | | | | | - Adarsh Barwad
- Pathology, All India Institute of Medical Sciences, New Delhi, India
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Vijay BK, Gopal D, Pawan Kumar G, Rao M. Spinal giant cell tumour presenting as a posterior mediastinal mass. BMJ Case Rep 2025; 18:e262838. [PMID: 40379300 DOI: 10.1136/bcr-2024-262838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2025] Open
Abstract
Posterior mediastinal masses frequently originate from neurogenic tumours; however, other possible causes include vascular abnormalities, cysts and primary bone tumours. We present a case involving a man in his 20s who experienced back pain, sudden sensorimotor weakness in both lower limbs and loss of bladder control. Imaging studies, including CT and MRI, identified a posterior mediastinal extramedullary mass associated with vertebral destruction and intrathecal extension. A biopsy of the mass confirmed it to be a giant cell tumour of bone. The patient was treated with denosumab, steroids and spinal decompression and was scheduled for definitive surgery. In young individuals presenting with a posterior mediastinal mass, signs of inflammation and early neurological symptoms, it is essential to consider primary bone tumours as a possible diagnosis.
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Affiliation(s)
- Balaji K Vijay
- Pulmonary Critical Care and Sleep Medicine, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India
| | - Durgeshwar Gopal
- Pulmonary Critical Care and Sleep Medicine, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India
| | - Garg Pawan Kumar
- Radiology, All India Institute of Medical Sciences Jodphur, Jodhpur, Rajasthan, India
| | - Meenakshi Rao
- Pulmonary Critical Care and Sleep Medicine, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India
- Department of Pathology & Lab Medicine, All India Institute of Medical sciences, Jodhpur, Rajasthan, India
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DENO Research Group, de la Calva C, Angulo M, González-Rojo P, Peiró A, Machado P, Cebrián JL, García-Maroto R, Valcárcel A, Puertas P, Valero-Cifuentes G, Pablos Ó, Maireles M, Fontalva ML, Chaves I, Orce A, Coll-Mesa L, Pérez I, González F, Sanz MDC, Gracia I. A Multicenter Study by the DENO Research Group on the Use of Denosumab in Giant-Cell Tumors of the Bone. J Clin Med 2025; 14:3242. [PMID: 40364272 PMCID: PMC12072718 DOI: 10.3390/jcm14093242] [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: 04/02/2025] [Revised: 05/05/2025] [Accepted: 05/05/2025] [Indexed: 05/15/2025] Open
Abstract
Background/Objectives: Despite the therapeutic potential of denosumab for the treatment of giant-cell tumors of the bone (GCTBs), there is a lack of standardization in treatment protocols. Methods: We present a multicenter, retrospective, descriptive study conducted across the seven hospitals in Spain affiliated with the DENO Research Group. Seventy-three patients diagnosed with GCTB and treated with denosumab were included and stratified according to treatment strategy-neoadjuvant (n = 38), adjuvant (n = 8), and single treatment (n = 27). Results: Patients in the neoadjuvant group received denosumab for a median of 6.1 months, with reintroduction after surgery in 25.8% of all cases. Among the neoadjuvant patients treated with curettage, recurrence was 35.5%, with no association with denosumab treatment duration (p = 0.274) nor with denosumab reintroduction after surgery (p = 0.405). In the adjuvant group, those who completed treatment received denosumab for 15.3 months, while those still undergoing therapy received it for a median of 12.8 months; only one case (12.5%) recurred. Recurrence rates in neoadjuvant and adjuvant treatment strategies were not different (p = 0.394). Patients treated only with denosumab and no longer on treatment had received it for 34.2 months, with 31.3% recurrence; those still on treatment had received it for 51.8 months, with 25.0% recurrence. Across all strategies, more than 85% of patients reported favorable clinical outcomes, and only 43.8% presented adverse events. No deaths occurred during this study. Conclusions: Although patients who experienced recurrence during neoadjuvant treatment had longer durations of denosumab administration, the difference was not statistically significant. Similarly, recurrence rates did not differ significantly, whether denosumab was reintroduced after surgery or not. Among the patients treated with curettage, recurrence rates were comparable between neoadjuvant and adjuvant strategies. Discontinuation of the single treatment did not necessarily result in disease progression.
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Affiliation(s)
| | - Carolina de la Calva
- Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain; (M.A.); (P.G.-R.)
| | - Manuel Angulo
- Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain; (M.A.); (P.G.-R.)
| | - Paula González-Rojo
- Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain; (M.A.); (P.G.-R.)
| | - Ana Peiró
- Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain; (A.P.); (P.M.); (I.G.)
| | - Pau Machado
- Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain; (A.P.); (P.M.); (I.G.)
| | - Juan Luis Cebrián
- Hospital Clínico San Carlos, 28040 Madrid, Spain; (J.L.C.); (R.G.-M.)
| | | | - Antonio Valcárcel
- Hospital Clínico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain; (A.V.); (P.P.); (G.V.-C.)
| | - Pablo Puertas
- Hospital Clínico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain; (A.V.); (P.P.); (G.V.-C.)
| | - Gregorio Valero-Cifuentes
- Hospital Clínico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain; (A.V.); (P.P.); (G.V.-C.)
| | - Óscar Pablos
- Hospital Universitario de Bellvitge, 08907 Barcelona, Spain; (Ó.P.); (M.M.); (M.L.F.)
| | - Miriam Maireles
- Hospital Universitario de Bellvitge, 08907 Barcelona, Spain; (Ó.P.); (M.M.); (M.L.F.)
| | - María Luisa Fontalva
- Hospital Universitario de Bellvitge, 08907 Barcelona, Spain; (Ó.P.); (M.M.); (M.L.F.)
| | - Iván Chaves
- Hospital Universitario Nuestra Señora de Candelaria, 38010 Santa Cruz de Tenerife, Spain; (I.C.); (A.O.); (L.C.-M.)
| | - Aida Orce
- Hospital Universitario Nuestra Señora de Candelaria, 38010 Santa Cruz de Tenerife, Spain; (I.C.); (A.O.); (L.C.-M.)
| | - Luis Coll-Mesa
- Hospital Universitario Nuestra Señora de Candelaria, 38010 Santa Cruz de Tenerife, Spain; (I.C.); (A.O.); (L.C.-M.)
| | - Israel Pérez
- Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (I.P.); (F.G.); (M.d.C.S.)
| | - Fausto González
- Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (I.P.); (F.G.); (M.d.C.S.)
| | - María del Carmen Sanz
- Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (I.P.); (F.G.); (M.d.C.S.)
| | - Isidro Gracia
- Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain; (A.P.); (P.M.); (I.G.)
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Luo X, Chen X. Capillary telangiectatic osteosarcoma misdiagnosed as aneurysmal bone cyst in a 12-year-old girl: A case report. Int J Surg Case Rep 2025; 129:111174. [PMID: 40157067 PMCID: PMC11995106 DOI: 10.1016/j.ijscr.2025.111174] [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: 12/21/2024] [Revised: 03/13/2025] [Accepted: 03/15/2025] [Indexed: 04/01/2025] Open
Abstract
INTRODUCTION AND IMPORTANCE Telangiectatic osteosarcoma (TOS) is a rare and aggressive subtype of osteosarcoma that is often misdiagnosed as more benign lesions, such as aneurysmal bone cysts (ABCs) or giant cell tumors (GCTs). The accurate differentiation between these conditions is crucial to ensure timely and appropriate treatment, as misdiagnosis can lead to delayed management and poor prognoses. CASE PRESENTATION We present the case of a 12-year-old girl who initially presented with left hip and proximal thigh pain, with imaging studies suggesting an ABC. Following curettage and grafting, the initial pathology report confirmed the diagnosis of ABC. However, the patient experienced rapid recurrence within two months, leading to further surgical intervention. A thorough re-evaluation of the pathological specimen revealed characteristics consistent with TOS, confirmed by immunohistochemical staining and molecular tests. The patient received four cycles of chemotherapy after the second surgery and underwent limb - salvage surgery 3 months after the operation. CLINICAL DISCUSSION This case highlights the challenges in diagnosing TOS due to its histological similarity to other giant cell-rich lesions. The initial misdiagnosis delayed the commencement of appropriate treatment. However, upon correct identification, the patient was treated with an effective chemotherapy regimen, including cisplatin, doxorubicin, and ifosfamide, resulting in significant tumor regression and control of lung metastases. CONCLUSION This case underscores the necessity for clinicians to maintain a high index of suspicion for TOS when evaluating aggressive bone lesions, particularly in pediatric patients. The importance of comprehensive pathological assessment, including immunohistochemistry and molecular analysis, cannot be overstated, as early and accurate diagnosis significantly influences treatment outcomes and prognosis.
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Affiliation(s)
- Xianyong Luo
- Department of Pediatric Surgery, The First Affiliated Hospital of Zhengzhou University, 450052 Zhengzhou City, Henan Province, China.
| | - Xinrang Chen
- Department of Pediatric Surgery, The First Affiliated Hospital of Zhengzhou University, 450052 Zhengzhou City, Henan Province, China
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DeFrancisis JS, Rosenthal OD, Whitford TC. Investigating the Challenges in Diagnosis and Management of Giant Cell Tumors in the Distal Phalanx: A Case Report. Cureus 2025; 17:e81180. [PMID: 40276445 PMCID: PMC12021378 DOI: 10.7759/cureus.81180] [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: 03/03/2025] [Accepted: 03/22/2025] [Indexed: 04/26/2025] Open
Abstract
Giant cell tumors (GCTs) of bone are locally aggressive neoplasms that typically occur in the distal femur or proximal tibia. Infrequently, they may develop in the bones of the hand, including the distal phalanx. This case highlights the importance of a thorough and systematic diagnostic workup of GCTs presenting in rare and challenging locations such as the distal phalanx. A 53-year-old male presented to the clinic with a several-month history of left middle fingertip enlargement, pain, and limited mobility. Plain film X-ray and magnetic resonance imaging revealed a lesion in the left middle distal phalanx. The patient underwent curettage with a working diagnosis of giant cell reparative granuloma with focal fracture callus. Eight months later the mass recurred and amputation of the distal phalanx tip was performed. The histopathological evaluation confirmed a diagnosis of a giant cell tumor of bone. The postoperative course was unremarkable. No further treatment was required. In rare and difficult-to-diagnose tumors clinicians should consult with experienced pathologists to improve diagnostic accuracy. This approach is essential for optimizing patient outcomes, preventing treatment delays, and reducing the risk of adverse events.
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Affiliation(s)
- Jason S DeFrancisis
- Orthopedic Surgery, Lake Erie College of Osteopathic Medicine, Bradenton, USA
- Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Oren D Rosenthal
- Anatomy, Lake Erie College of Osteopathic Medicine, Bradenton, USA
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Hosseini H, Heydari S, Hushmandi K, Daneshi S, Raesi R. Bone tumors: a systematic review of prevalence, risk determinants, and survival patterns. BMC Cancer 2025; 25:321. [PMID: 39984867 PMCID: PMC11846205 DOI: 10.1186/s12885-025-13720-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2025] [Accepted: 02/12/2025] [Indexed: 02/23/2025] Open
Abstract
BACKGROUND Though relatively rare, bone tumors significantly impact patient health and treatment outcomes. OBJECTIVE This systematic review analyzes the incidence, types, survival rates, and risk factors associated with bone tumors, including both benign and malignant forms. METHODS This systematic review was conducted using the keywords "bone tumors," "epidemiology," "benign bone tumors," "malignant bone tumors," "osteosarcoma," "Ewing sarcoma," "chondrosarcoma," "risk factors," and "survival" in electronic databases including PubMed, Scopus, Web of Science, and Google Scholar from 2000 to 2024. The search strategy was based on the PRISMA statement. Finally, 9 articles were selected for inclusion in the study. RESULTS The systematic review highlights that primary bone tumors can be classified into benign and malignant types, with osteosarcoma being the most prevalent malignant form, particularly among adolescents and young adults. The epidemiology of bone tumors is influenced by factors such as age, gender, geographic location, and genetic predispositions. Recent advancements in imaging techniques have improved the detection of these tumors, contributing to an increasing recognition of their prevalence. Data shows that the limited-duration prevalence of malignant bone tumors has increased significantly. This increase is from 0.00069% in 2000 to 0.00749% in 2018, indicating an increasing recognition and diagnosis of these rare tumors over time. Survival rates vary significantly by tumor type, with approximately 50-60% for osteosarcoma and around 70% for Ewing's sarcoma, though these rates decrease with metastasis. Key risk factors identified include genetic predispositions such as Li-Fraumeni syndrome and TP53 mutations, environmental exposures like radiation, and growth patterns related to height. CONCLUSION The review highlights the importance of early diagnosis and treatment intervention, as survival rates are significantly better for patients with localized disease compared to those with metastatic conditions. The observed variations in survival rates across different tumor types underscore the need for tailored treatment strategies. Key risk factors include genetic predispositions and environmental exposures, highlighting the need for targeted screening and ongoing research to enhance diagnostic accuracy and treatment strategies.
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Affiliation(s)
- Hasan Hosseini
- Department of Orthopedics, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sina Heydari
- School of Medicine, Imam Khomeini Hospital, Jiroft University of Medical Science, Jiroft, Iran
| | - Kiavash Hushmandi
- Nephrology and Urology Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Salman Daneshi
- Department of Public Health, School of Health, Jiroft University of Medical Sciences, Jiroft, Iran.
| | - Rasoul Raesi
- Department of Public Health, School of Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran.
- Department of Health Services Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
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Fellows D, Kotowska J, Stevenson T, Brown J, Orosz Z, Siddiqi A, Whitwell D, Cosker T, GIbbons CLMH. Management and surveillance of metastatic giant cell tumour of bone. Pathol Oncol Res 2025; 31:1611916. [PMID: 40046036 PMCID: PMC11879744 DOI: 10.3389/pore.2025.1611916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Accepted: 02/05/2025] [Indexed: 05/13/2025]
Abstract
Giant cell tumour of bone (GCTB) is viewed as a benign, locally aggressive primary bone tumour with metastatic potential. Current management is surgery with bone curettage or resection and systemic therapy with denosumab. Diagnosis is confirmed histologically prior to surgery, with staging for pulmonary disease, as pulmonary metastases (PM) reportedly occur in <8%. This study aimed to assess incidence, surveillance and management of PM in patients with GCTB, with histopathological review. A retrospective audit of the Oxford bone tumour registry was performed from January 2014 - October 2023. Inclusion criterion was histological confirmation of GCTB. Exclusion criteria were incomplete medical, imaging or histology records, or referral for secondary MDT opinion for diagnosis. From an initial group of 126 GCTB patients, 83 patients met the full selection criteria. Pulmonary metastases were identified in 11 patients. Three with PM were excluded on histopathological review as being giant cell rich osteosarcoma rather than metastatic GCTB. This left 8 (9.6%) patients, one had PM at presentation and seven at follow-up between 2 and 42 months. Two were histologically confirmed after cardiothoracic surgery and biopsy, six radiologically diagnosed. Three (37.5%) patients with PM have died (between 1 and 12 months after confirmed PM), five are alive with stable disease. Seven (87.5%) of patients with pulmonary disease were treated with denosumab/chemotherapy (three before, four after pulmonary diagnosis). Five (62.5%) with pulmonary disease had recurrence of local disease requiring further surgery. Local recurrence was an independent risk factor for PM on statistical analysis. GCTB may present with PM, but more commonly, metastasis occurs after surgery, presenting on surveillance and can progress. There were no distinct differences in histopathological appearance between patients with GCTB that developed PM and those that did not, therefore morphological features of the tumour cannot be currently used to predict tumour behaviour. PM can behave aggressively, necessitating identifying histological markers to recognise patients at risk of metastatic GCTB, for example, through mRNA single cell analysis. We propose GCTB patients with PM receive regular chest surveillance with PET scan and/or CT to monitor disease progression, and a multi-centre audit of GCTB outcome undertaken to further define optimal clinical management.
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Affiliation(s)
- David Fellows
- Oxford Sarcoma Service, Nuffield Orthopaedic Centre, Oxford, England, United Kingdom
| | - Julia Kotowska
- Trauma and Orthopaedics, Hampshire Hospitals NHS Foundation Trust, Basingstoke, United Kingdom
| | - Thomas Stevenson
- Trauma and Orthopaedics, Institute of Naval Medicine, Alverstoke, United Kingdom
| | - Jennifer Brown
- Oxford Sarcoma Service, Nuffield Orthopaedic Centre, Oxford, England, United Kingdom
| | - Zsolt Orosz
- Oxford Sarcoma Service, Nuffield Orthopaedic Centre, Oxford, England, United Kingdom
| | - Ather Siddiqi
- Oxford Sarcoma Service, Nuffield Orthopaedic Centre, Oxford, England, United Kingdom
| | - Duncan Whitwell
- Oxford Sarcoma Service, Nuffield Orthopaedic Centre, Oxford, England, United Kingdom
| | - Thomas Cosker
- Oxford Sarcoma Service, Nuffield Orthopaedic Centre, Oxford, England, United Kingdom
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Qin Z, Li L, Jing T, Wang C. Case report: A rare case of chondrosarcoma-like malignant giant cell tumor in adolescent rib: diagnostic challenges and treatment. Front Oncol 2025; 14:1523104. [PMID: 39882444 PMCID: PMC11774699 DOI: 10.3389/fonc.2024.1523104] [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: 11/05/2024] [Accepted: 12/24/2024] [Indexed: 01/31/2025] Open
Abstract
Chondrosarcoma-like malignant giant cell tumor (GCT) of the rib is an extremely rare and aggressive tumor, particularly in adolescents. This case report describes a 19-year-old female presenting with a GCT of the rib with chondrosarcomatous differentiation, highlighting the challenges posed by its unusual location and pathological complexity. Multidisciplinary diagnostic approaches, including advanced imaging, immunohistochemistry (IHC), and pathology, were essential for confirming the diagnosis. Key IHC markers such as Vimentin, SMA, and CD163, alongside genetic analysis excluding H3F3A mutations, guided the diagnostic process. The patient underwent successful surgical resection, achieving early recovery without adjuvant therapy. This report underscores the importance of early detection, precise pathological evaluation, and individualized surgical treatment for rare and high-risk tumors, emphasizing the need for long-term follow-up to monitor recurrence.
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Affiliation(s)
- Zhuolin Qin
- The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Longqian Li
- The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Tao Jing
- Department of Thoracic Surgery, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Cheng Wang
- Department of Thoracic Surgery, Lanzhou University Second Hospital, Lanzhou, Gansu, China
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Ba PA, Ndiaye RAM, Diao S, Diop B, Diouf AB. Giant cell tumor of the talus: A case report and literature review. Int J Surg Case Rep 2025; 126:110695. [PMID: 39708724 PMCID: PMC11726791 DOI: 10.1016/j.ijscr.2024.110695] [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: 10/15/2024] [Revised: 11/24/2024] [Accepted: 11/28/2024] [Indexed: 12/23/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Giant cell tumor is a benign primary bone tumor of mesenchymal origin that mainly affects the long bones. Involvement of the bones of the foot is rare with an incidence of 1 to 2 %. We report a case of giant cell tumor of the talus in a 36-year-old man. CASE PRESENTATION A 36-year-old tailor with no past medical history presented with pain in the left ankle. The symptoms had been present for approximately three years. A small, non-inflammatory swelling was observed on the anteromedial side of the ankle. The range of motion of the ankle was normal and painless in all planes. X-rays of the ankle revealed a well-defined lytic lesion at the neck of the talus without periosteal reaction. An MRI was performed, revealing a lytic pattern in the inner half of the talus, which expanded and thinned the cortex without obvious signs of breakthrough. The diagnosis was confirmed by a biopsy, which revealed a giant cell tumor of the talus without any signs of malignancy. Surgical treatment by tibiocalcaneal arthrodesis was performed. CLINICAL DISCUSSION Giant cell tumor is a benign tumor that usually occurs in long bones in 85 % of cases, with 10 % of cases reported in the axial skeleton. Its location in the bones of the foot is uncommon, with an incidence ranging from 1 to 2 %. CONCLUSION Giant cell tumor is a benign but locally aggressive tumor. Talectomy associated with arthrodesis is a viable therapeutic alternative for extensive destructive lesions.
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DENO Research Group, de la Calva C, Angulo M, González‐Rojo P, Peiró A, Machado P, Cebrián JL, García‐Maroto R, Valcárcel A, Puertas P, Valero‐Cifuentes G, Pablos Ó, Maireles M, Fontalva ML, Chaves I, Orce A, Coll‐Mesa L, Pérez I, González F, del Carmen Sanz M, Gracia I. Do Unresectable Giant Cell Tumors of Bone Treated With Denosumab Progress After Discontinuation of Treatment? Cancer Rep (Hoboken) 2025; 8:e70117. [PMID: 39797695 PMCID: PMC11726647 DOI: 10.1002/cnr2.70117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 12/16/2024] [Accepted: 12/24/2024] [Indexed: 01/13/2025] Open
Abstract
BACKGROUND Denosumab represents a valuable treatment option for unresectable giant cell tumors of the bone (GCTBs). However, no standardized protocols exist determining the length of administration, with few studies having been published on patients who reached the end of treatment. AIMS To analyze the outcomes of patients diagnosed with GCTB and who had finished single treatment with denosumab. METHODS AND RESULTS This is a multicenter, retrospective, descriptive study carried out in seven Spanish hospitals with multidisciplinary sarcoma and musculoskeletal tumor boards, between 2009 and 2019. Sixteen patients diagnosed with unresectable GCTBs and treated with denosumab who had reached the end of their treatment were recruited for the study and had been followed up for a minimum of 2 years. Fifty percent of patients discontinued denosumab after showing signs of tumor control. The disease remained stable in 69% of patients (n = 11), with a median recurrence-free survival time of 46 months (20-157 months) after being treated for a median period of 19 months (5-83 months). Four patients experienced local progression, and one presented multifocal progression. These five patients were treated for a median period of 46 months (14-76 months), with a median recurrence-free survival time of 9 months (5-25 months). CONCLUSION The findings of the present study suggest that discontinuation of denosumab in patients with unresectable GCTB is not necessarily associated with the progression of the disease. Further research is needed to determine how long denosumab should be administered to minimize the risk of recurrence.
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Affiliation(s)
| | | | - Manuel Angulo
- Hospital Universitario y Politécnico La FeValenciaSpain
| | | | - Ana Peiró
- Hospital de la Santa Creu i Sant PauBarcelonaSpain
| | - Pau Machado
- Hospital de la Santa Creu i Sant PauBarcelonaSpain
| | | | | | | | - Pablo Puertas
- Hospital Clínico Universitario Virgen de la ArrixacaMurciaSpain
| | | | - Óscar Pablos
- Hospital Universitario de BellvitgeL'Hospitalet de LlobregatSpain
| | - Miriam Maireles
- Hospital Universitario de BellvitgeL'Hospitalet de LlobregatSpain
| | | | - Iván Chaves
- Hospital Universitario Nuestra Señora de CandelariaSanta Cruz de TenerifeSpain
| | - Aida Orce
- Hospital Universitario Nuestra Señora de CandelariaSanta Cruz de TenerifeSpain
| | - Luis Coll‐Mesa
- Hospital Universitario Nuestra Señora de CandelariaSanta Cruz de TenerifeSpain
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Fraga de Abreu VH, Pacheco R, Cunha F, Borges A. Giant cell tumour of the larynx-a diagnostic challenge. BJR Case Rep 2025; 11:uaaf006. [PMID: 39958675 PMCID: PMC11828855 DOI: 10.1093/bjrcr/uaaf006] [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: 10/05/2024] [Revised: 01/15/2025] [Accepted: 01/20/2025] [Indexed: 02/18/2025] Open
Abstract
Giant cell tumours (GCTs) of the larynx are extremely rare. The most affected structure is the thyroid cartilage and only 44 cases are reported in the literature.1 Clinically, their first manifestation is usually a palpable neck mass, often accompanied by hoarseness, dyspnoea, and/or dysphagia depending on size and location. GCTs are benign neoplasms, yet awareness of this entity is crucial as their aggressive local behaviour can cause significant morbidity with airway obstruction and can simulate a malignancy. The differential diagnosis is broad and remains a clinical and radiological challenge. Indeed, the final diagnosis is established by histology postoperatively. Surgery is the preferred treatment but may impair voice quality. For incomplete surgical resections and high surgical risk lesions, denosumab treatment is a valuable option. We share our experience on GCTs in a young adult presenting as a supraglottic mass.
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Affiliation(s)
| | - Ricardo Pacheco
- 2, Otolaryngology Department, Portuguese Institute of Oncology Francisco Gentil, 1099-023 Lisbon, Portugal
| | - Fernando Cunha
- Pathology Department, Portuguese Institute of Oncology Francisco Gentil, 1099-023 Lisbon, Portugal
| | - Alexandra Borges
- Radiology Department, Portuguese Institute of Oncology Francisco Gentil, 1099-023 Lisbon, Portugal
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14
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Alolayan OA, Korkoman AJ, Alnasser AA. Giant cell tumor of the cervical spine: A case report. Int J Surg Case Rep 2025; 126:110676. [PMID: 39631119 PMCID: PMC11652928 DOI: 10.1016/j.ijscr.2024.110676] [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: 08/09/2024] [Revised: 11/12/2024] [Accepted: 11/27/2024] [Indexed: 12/07/2024] Open
Abstract
INTRODUCTION A Giant Cell Tumor (GCT) of the bone is a locally osteolytic tumor made up of mononuclear ovoid stromal cells and multinucleated giant cells. It commonly affects long bones like the distal femur and proximal tibia, but can also develop in the cervical spine during the third and fourth decades of life. PRESENTATION OF CASE A 20-year-old female presented to the clinic with a complaint of neck pain persisting for one month. Clinical examination revealed bilateral radiculopathy in the upper limb, which was also associated with pain in the left shoulder and elbow. Imaging revealed a destructive lesion in the 7th cervical vertebra (C7). A biopsy was done which indicated a giant cell tumor (GCT). A C7 corpectomy was performed, which included the removal of the C7 vertebral body and application of a cage. At the two-year follow-up, the patient remained asymptomatic, and radiographs showed no signs of recurrence. DISCUSSION A Giant Cell Tumor (GCT) occurring above the sacrum, especially in the cervical spine, is extremely rare. Symptoms of GCT are often nonspecific and can include neck pain, numbness, and weakness in the upper limbs, which are sometimes mistaken for myalgia or disc disease. The main treatment goal for GCT is "en bloc" resection while preserving the joint, though this can be challenging, particularly in spinal cases. CONCLUSION It is crucial to acknowledge that GCT can appear in uncommon sites and age groups. Surgeons must have a high level of awareness and perform an adequate preoperative workup, before definitive treatment. The patient should undergo regular follow-ups to detect any recurrence or metastasis at an early stage.
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Affiliation(s)
| | | | - Abdullah Adel Alnasser
- Orthopedic Surgery Department at Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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15
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Henderson RD, Shirodkar K, Hussein M, Jenko N, Jeys L, Botchu R. Measurable progression of giant cell tumour of bone associated with pregnancy - A tertiary sarcoma centre analysis. J Clin Orthop Trauma 2024; 59:102825. [PMID: 39650720 PMCID: PMC11617685 DOI: 10.1016/j.jcot.2024.102825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 10/26/2024] [Accepted: 11/14/2024] [Indexed: 12/11/2024] Open
Abstract
Introduction Giant cell tumour of bone (GCTB) is a benign but locally aggressive bone tumour with a higher predilection for females of reproductive age. GCTB management poses a unique set of challenges during pregnancy due to risks associated with imaging and treatment options. Pregnancy has been implicated in GCTB progression and tumour recurrence, however an exact mechanism has not been established. This study aims to confirm the relationship between the diagnosis and progression of GCTB during pregnancy. Methods A 17-year retrospective analysis of our tertiary sarcoma referral centre database was performed to identify the relevant patients. Pregnancy-associated tumours were defined by those already present or diagnosed during pregnancy, and up to 12 months postpartum. Lesion volume was determined by mathematical ellipsoidal modelling technique to simplify the estimation, with cross-sectional measurements obtained from the three standard orthogonal planes on initial and surveillance imaging. Due to logistical challenges, follow-up imaging was performed at either our tertiary sarcoma centre or under guidance at regional imaging centres convenient to the patient. Results The diagnosis of GCTB was made in 113 female patients during this 17-year period, of which 20 were associated with pregnancy with a mean age of 28.8 years (range 19-40 years). 12 patients had their primary or recurrent GCTB diagnosed, or known tumour progress during pregnancy, whilst the remaining 8 were diagnosed shortly thereafter to within 12 months postpartum. The most common tumour sites were located around the knee (30 %) and distal radius (25 %). A statistically significant pattern of growth was observed through the surveillance period (p 0.018), within a relatively short mean follow-up period of only 89.8 days (SD 54.5; 13-192 days). Conclusion This study demonstrates the significant association that pregnancy has with the growth and progression of both primary and recurrent GCTB. Pregnant patients should be subject to close surveillance well into the postpartum period due to possible accelerated disease progression and potential for disease recurrence.
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Affiliation(s)
- RD Henderson
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, UK
| | - K Shirodkar
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, UK
| | - M Hussein
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, UK
| | - N Jenko
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, UK
| | - L Jeys
- Department of Orthopaedic Oncology, Royal Orthopaedic Hospital, Birmingham, UK
| | - R Botchu
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, UK
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Ferlauto HR, Belanger B, Lazarides AL, Visgauss JD, Brigman BE, Eward WC. Locking plate augmentation of polymethylmethacrylate-filled distal femoral defects: A biomechanical study. J Orthop Res 2024. [PMID: 39219262 DOI: 10.1002/jor.25965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 07/15/2024] [Accepted: 08/13/2024] [Indexed: 09/04/2024]
Abstract
Benign, locally aggressive tumors of the distal femur are typically treated with intralesional curettage and polymethylmethacrylate (PMMA) cementation. However, it is not known whether plate fixation should be added to biomechanically augment these PMMA-filled defects. The purpose of this study was to evaluate the performance of two competing techniques for reconstruction of a distal femoral defect. For this biomechanical study, we used 12 composite femurs with properties comparable to bone. In nine femurs, identical contained medial distal femoral defects were created using a robotic arm. Group A contained three intact femurs, Group B three femurs with an unfilled defect, Group C three femurs reconstructed with PMMA alone, and Group D three femurs reconstructed with PMMA plus a medial locking plate. Locations of greatest stress concentration were determined by PhotoStress analysis, then three strain gauges were applied to each specimen at these high-stress locations. Specimens were loaded within a physiologic range followed by loading to failure. Outcome measures included construct stiffness, strain along the distal femur, and load at failure. Results showed that stiffness and strain were not significantly different between reconstructive techniques; however, both techniques reduced tensile strain along the popliteal surface by approximately 40% compared to non-reconstructed specimens. All specimens failed at the femoral neck before failing at the distal femur. These findings suggest that plate augmentation of PMMA-filled distal femoral defects like the one in this study offers insignificant biomechanical benefit within physiologic loads and therefore may be unnecessary.
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Affiliation(s)
- Harrison R Ferlauto
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Bruno Belanger
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Alexander L Lazarides
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Julia D Visgauss
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Brian E Brigman
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - William C Eward
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
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Jain A, Aggrawal A, Sahu A, Agarwal R, Tiwari A. Management of Giant Cell Tumor of Distal Radius-Does Curettage Work? Indian J Surg Oncol 2024; 15:578-583. [PMID: 39239445 PMCID: PMC11371959 DOI: 10.1007/s13193-024-01952-8] [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: 08/13/2023] [Accepted: 05/02/2024] [Indexed: 09/07/2024] Open
Abstract
Giant cell tumor affecting distal radius has been considered more aggressive, as compared to its counterparts in other locations. While resection has been advocated as the treatment of choice with lower rates of recurrence, curettage has reportedly led to superior functional outcomes. This retrospective study aimed to evaluate the functional and oncological outcomes of patients managed for GCT distal radius by either extended intralesional curettage (EIC) or resection and arthrodesis with radialisation of ulna (RRU), with respect to rates of local recurrence and function. Twenty-four patients operated for giant cell tumor of distal radius by a single surgeon from 2011 to 2021, were included in the study. The demographic, clinico-radiological, and surgical details were recorded and analyzed, as were the functional and oncological outcomes. At a median (IQR) follow-up of 6.3 years (range 2 years to 15.9 years), the rate of recurrence in curettage was found to be higher than that in resection but was not statistically significant (35.7% vs 20%, p > 0.05). Patients managed elsewhere and then presented to us for recurrence had a higher rate of local recurrence (66.6%, p = 0.01). Average time to recurrence was 14 months (range 2-24 months). On final follow-up, patients in curettage group had better functional outcomes in terms of grip strength and range of motion. Mean Modified Mayo Wrist score and MSTS score were 78.2 and 25.63, respectively, for EIC group and 69.6 and 25.75, respectively, for RRU group. Extended intralesional curettage resulted in an earlier rehabilitation with a mobile wrist and acceptable disease control when compared with resection and arthrodesis with radialisation of ulna.
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Affiliation(s)
| | - Anu Aggrawal
- Musculoskeletal Oncology Division, Department of Surgical Oncology, Max Institute of Cancer Care, Max Super Specialty Hospital, Press Enclave Road, Saket, New Delhi, India
| | - Amit Sahu
- Department of Radiology, Max Institute of Cancer Care, Max Super Specialty Hospital, Saket, New Delhi, India
| | - Riti Agarwal
- Department of Pathology, Max Institute of Cancer Care, Max Super Specialty Hospital, Saket, New Delhi, India
| | - Akshay Tiwari
- Musculoskeletal Oncology Division, Department of Surgical Oncology, Max Institute of Cancer Care, Max Super Specialty Hospital, Press Enclave Road, Saket, New Delhi, India
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Agostinis C, Lupi E. Case 328: Brown Tumor in Hyperparathyroidism Due to Parathyroid Adenoma. Radiology 2024; 312:e222538. [PMID: 39189912 DOI: 10.1148/radiol.222538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
HISTORY A 45-year-old female patient with diffuse osteoarticular pain, particularly low back pain, was referred by a rheumatologist for an updated radiologic evaluation. The patient had experienced these symptoms for many years and was diagnosed with human leukocyte antigen B27-negative spondyloarthritis approximately 11 years prior, based on findings of bilateral erosive sacroiliitis at pelvic radiography and bone scintigraphy with technetium 99m (99mTc) methylene diphosphonate. After 3 years of treatment with a tumor necrosis factor-α inhibitor (adalimumab), which was effective for pain, the patient was lost to follow-up. At the current presentation, approximately 8 years after being lost to follow-up, the patient presented with worsening low back pain. The presence of nonobstructing kidney stones on US images confounded the underlying cause of worsening pain. The patient also experienced fatigue and depressed mood. Routine blood tests revealed a normal blood cell count, creatinine level of 0.64 mg/dL (56.58 μmol/L) (normal range, 0.30-1.1 mg/dL [26.52-97.24 μmol/L]), C-reactive protein level of 1.1 mg/dL (normal, <1 mg/dL), and vitamin D level of 21 ng/mL (52.42 nmol/L) (normal range, 30-100 ng/mL [74.88-249.60 nmol/L]). Noncontrast MRI of the thoracic and lumbar spine, MRI of the sacroiliac joints, and CT of the abdomen and pelvis were performed.
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Affiliation(s)
- Cristina Agostinis
- From the Department of Neuroradiology (C.A.) and Rheumatology Unit (E.L.), ASST Papa Giovanni XXIII Hospital, Piazza OMS 1, 24124 Bergamo, Italy
| | - Elide Lupi
- From the Department of Neuroradiology (C.A.) and Rheumatology Unit (E.L.), ASST Papa Giovanni XXIII Hospital, Piazza OMS 1, 24124 Bergamo, Italy
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Xie Z, Zhao H, Song L, Ye Q, Zhong L, Li S, Zhang R, Wang M, Chen X, Lu Z, Yang W, Zhao Y. A radiograph-based deep learning model improves radiologists' performance for classification of histological types of primary bone tumors: A multicenter study. Eur J Radiol 2024; 176:111496. [PMID: 38733705 DOI: 10.1016/j.ejrad.2024.111496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 04/03/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024]
Abstract
PURPOSE To develop a deep learning (DL) model for classifying histological types of primary bone tumors (PBTs) using radiographs and evaluate its clinical utility in assisting radiologists. METHODS This retrospective study included 878 patients with pathologically confirmed PBTs from two centers (638, 77, 80, and 83 for the training, validation, internal test, and external test sets, respectively). We classified PBTs into five categories by histological types: chondrogenic tumors, osteogenic tumors, osteoclastic giant cell-rich tumors, other mesenchymal tumors of bone, or other histological types of PBTs. A DL model combining radiographs and clinical features based on the EfficientNet-B3 was developed for five-category classification. The area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity were calculated to evaluate model performance. The clinical utility of the model was evaluated in an observer study with four radiologists. RESULTS The combined model achieved a macro average AUC of 0.904/0.873, with an accuracy of 67.5 %/68.7 %, a macro average sensitivity of 66.9 %/57.2 %, and a macro average specificity of 92.1 %/91.6 % on the internal/external test set, respectively. Model-assisted analysis improved accuracy, interpretation time, and confidence for junior (50.6 % vs. 72.3 %, 53.07[s] vs. 18.55[s] and 3.10 vs. 3.73 on a 5-point Likert scale [P < 0.05 for each], respectively) and senior radiologists (68.7 % vs. 75.3 %, 32.50[s] vs. 21.42[s] and 4.19 vs. 4.37 [P < 0.05 for each], respectively). CONCLUSION The combined DL model effectively classified histological types of PBTs and assisted radiologists in achieving better classification results than their independent visual assessment.
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Affiliation(s)
- Zhuoyao Xie
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics, Guangdong Province), 183 Zhongshan Da Dao Xi, Guangzhou, Guangdong, 510630, China.
| | - Huanmiao Zhao
- Guangdong Provincial Key Laboratory of Medical Image Processing, School of Biomedical Engineering, Southern Medical University, 1023 Shatai Road, Baiyun District, Guangzhou, 510515, Guangdong, China.
| | - Liwen Song
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics, Guangdong Province), 183 Zhongshan Da Dao Xi, Guangzhou, Guangdong, 510630, China.
| | - Qiang Ye
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics, Guangdong Province), 183 Zhongshan Da Dao Xi, Guangzhou, Guangdong, 510630, China.
| | - Liming Zhong
- Guangdong Provincial Key Laboratory of Medical Image Processing, School of Biomedical Engineering, Southern Medical University, 1023 Shatai Road, Baiyun District, Guangzhou, 510515, Guangdong, China.
| | - Shisi Li
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics, Guangdong Province), 183 Zhongshan Da Dao Xi, Guangzhou, Guangdong, 510630, China.
| | - Rui Zhang
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics, Guangdong Province), 183 Zhongshan Da Dao Xi, Guangzhou, Guangdong, 510630, China.
| | - Menghong Wang
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics, Guangdong Province), 183 Zhongshan Da Dao Xi, Guangzhou, Guangdong, 510630, China.
| | - Xiaqing Chen
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics, Guangdong Province), 183 Zhongshan Da Dao Xi, Guangzhou, Guangdong, 510630, China.
| | - Zixiao Lu
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics, Guangdong Province), 183 Zhongshan Da Dao Xi, Guangzhou, Guangdong, 510630, China.
| | - Wei Yang
- Guangdong Provincial Key Laboratory of Medical Image Processing, School of Biomedical Engineering, Southern Medical University, 1023 Shatai Road, Baiyun District, Guangzhou, 510515, Guangdong, China.
| | - Yinghua Zhao
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics, Guangdong Province), 183 Zhongshan Da Dao Xi, Guangzhou, Guangdong, 510630, China.
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Expósito D, Martel J, Alvarez de Sierra B, Bueno A, Vilanova C, Vilanova JC. Neoplastic and Non-neoplastic Bone Lesions of the Knee. Semin Musculoskelet Radiol 2024; 28:225-247. [PMID: 38768589 DOI: 10.1055/s-0044-1781471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Numerous anatomical variants are described around the knee, many of which look like bony lesions, so it is important to know them to avoid unnecessary complementary tests and inadequate management. Likewise, several alterations in relation to normal development can also simulate bone lesions.However, numerous pathologic processes frequently affect the knee, including traumatic, inflammatory, infectious, and tumor pathology. Many of these entities show typical radiologic features that facilitate their diagnosis. In other cases, a correct differential diagnosis is necessary for proper clinical management.Despite the availability of increasingly advanced imaging techniques, plain radiography is still the technique of choice in the initial study of many of these pathologies. This article reviews the radiologic characteristics of tumor and nontumor lesions that may appear around the knee to make a correct diagnosis and avoid unnecessary complementary radiologic examinations and inadequate clinical management.
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Affiliation(s)
- Diana Expósito
- Department of Radiology, Hospital Sanitas La Moraleja, Madrid, Spain
| | - José Martel
- Department of Radiology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | - Angel Bueno
- Department of Radiology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Cristina Vilanova
- Department of Orthopaedic Surgery, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Joan C Vilanova
- Department of Radiology, Clínica Girona, Institute of Diagnostic Imaging (IDI) Girona, University of Girona, Girona, Spain
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Nishio J, Nakayama S, Koga K, Aoki M. Keratin-Positive Giant Cell-Rich Tumor: A Review and Update. Cancers (Basel) 2024; 16:1940. [PMID: 38792018 PMCID: PMC11120402 DOI: 10.3390/cancers16101940] [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: 04/26/2024] [Revised: 05/16/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024] Open
Abstract
Keratin-positive giant cell-rich tumor (KPGCT) is an extremely rare and recently described mesenchymal neoplasm that occurs in both soft tissue and bone, frequently found in young women. It has locally recurrent potential if incompletely excised but low risk for metastasis. KPGCT is histologically similar to conventional giant cell tumors of soft tissue but shows the presence of keratin-positive mononuclear cells. Interestingly, KPGCT also shares some morphological features with xanthogranulomatous epithelial tumors. These two tumors have recently been shown to harbor an HMGA2-NCOR2 fusion, arguing in favor of a single entity. Surgery is the treatment of choice for localized KPGCT. Therapeutic options for advanced or metastatic disease are unknown. This review provides an overview of the current knowledge on the clinical presentation, pathogenesis, histopathology, and treatment of KPGCT. In addition, we will discuss the differential diagnosis of this emerging entity.
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Affiliation(s)
- Jun Nishio
- Section of Orthopaedic Surgery, Department of Medicine, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka 814-0193, Japan
| | - Shizuhide Nakayama
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan;
| | - Kaori Koga
- Department of Pathology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; (K.K.); (M.A.)
| | - Mikiko Aoki
- Department of Pathology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; (K.K.); (M.A.)
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Cui H, Li J, Zheng K, Xu M, Zhang G, Hu Y, Yu X. Microwave-assisted intralesional curettage combined with other adjuvant methods for treatment of Campanacci III giant cell tumor of bone in distal radius: a multicenter clinical study. Front Oncol 2024; 14:1383247. [PMID: 38764573 PMCID: PMC11099234 DOI: 10.3389/fonc.2024.1383247] [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: 02/07/2024] [Accepted: 04/18/2024] [Indexed: 05/21/2024] Open
Abstract
Objective To compare the clinical outcomes of microwave-assisted intralesional curettage(MAIC) with those of en bloc resection and autogenous fibular reconstruction (EBR-AFR) for treating grade III giant cell tumor of the bone (GCTB) of the distal radius and to elucidate the indications for wrist preservation surgery. Materials and methods In this retrospective study, 19 patients with grade III GCTB of the distal radius who underwent surgery at three medical institutions were included and categorized based on their surgical pattern. Seven patients underwent MAIC and internal fixation with bone cement (MAIC group) and 12 underwent EBR-AFR (EBR-AFR group). To evaluate the function of the affected limb postoperatively, wrist range of motion, grip strength, Musculoskeletal Tumor Society (MSTS) scores were recorded. Results The follow-up time of the MAIC group was 73.57 ± 28.61 (36-116) months, with no recurrence or lung metastasis. In contrast, the follow-up time of the EBR-AFR group was 55.67 ± 28.74 (36-132) months, with 1 case of local recurrence (8.3%, 1/12) and 1 case of lung metastasis (8.3%, 1/12). The wrist flexion, extension, supination, pronation, grip strength were better in the MAIC group than in the EBR-AFR group. Although there was no statistically significant difference in the MSTS score between the two groups, it is noteworthy that the MAIC group exhibited significantly superior emotional acceptance and hand positioning compared to the EBR-AFR group(p < 0.05). Conclusion The functional outcomes of the MAIC group are better. The treatment strategy for grade III GCTB of the distal radius should be determined based on the specific preoperative imaging findings. Nevertheless, MAIC can be the preferred surgical approach for most patients with grade III GCTB of the distal radius, particularly for young patients.
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Affiliation(s)
- Haocheng Cui
- Orthopedic Department, 960 Hospital of People’s Liberation Army, Jinan, Shandong, China
| | - Jianhua Li
- Orthopedic Department, 960 Hospital of People’s Liberation Army, Jinan, Shandong, China
| | - Kai Zheng
- Orthopedic Department, 960 Hospital of People’s Liberation Army, Jinan, Shandong, China
| | - Ming Xu
- Orthopedic Department, 960 Hospital of People’s Liberation Army, Jinan, Shandong, China
| | - Guochuan Zhang
- Department of Musculoskeletal Tumor, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yongcheng Hu
- Department of Bone Oncology, Tianjin Hospital, Tianjin, China
| | - Xiuchun Yu
- Orthopedic Department, 960 Hospital of People’s Liberation Army, Jinan, Shandong, China
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23
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Patton A, Ilaslan H, Armstrong SM, Bakhshwin A, Cheng YW, Minhas F, Fritchie KJ. Keratin-Positive Giant Cell-Rich Tumor of Bone Harboring an HMGA2::NCOR2 Fusion: Two Cases, Including a Patient With Metastatic Disease, and Review of the Literature. Int J Surg Pathol 2024; 32:556-564. [PMID: 37461232 DOI: 10.1177/10668969231185076] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Giant cell-rich lesions of bone represent a heterogeneous group of entities which classically include giant cell tumor of bone, aneurysmal bone cyst, nonossifying fibroma, and Brown tumor of hyperparathyroidism. A recently described subset of giant cell-rich tumors involving bone and soft tissue has been characterized by recurrent HMGA2::NCOR2 fusions and keratin expression. The overlapping clinical, radiographic, and morphological features of these giant cell-rich lesions provide a unique diagnostic challenge, particularly on biopsy. We present 2 additional cases of keratin-positive giant cell-rich tumor of bone with HMGA2::NCOR2 fusions, including 1 patient who developed metastatic disease.
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Affiliation(s)
- Ashley Patton
- Department of Pathology & Laboratory Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Hakan Ilaslan
- Department of Musculoskeletal Radiology, Cleveland Clinic, Cleveland, OH, USA
| | - Susan M Armstrong
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Ahmed Bakhshwin
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Yu-Wei Cheng
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Farooq Minhas
- Department of Pathology, Ascension Providence Hospital, Southfield, MI, USA
| | - Karen J Fritchie
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
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24
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Srinivas M, Nichkaode P, Sharma B, Haval S. Giant Cell Tumor of the Anterior Arc of the Rib: A Case Report. Cureus 2024; 16:e58679. [PMID: 38774168 PMCID: PMC11107139 DOI: 10.7759/cureus.58679] [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] [Accepted: 04/21/2024] [Indexed: 05/24/2024] Open
Abstract
Tumors that develop on the chest wall are usually rare. This case report highlights a rare occurrence of a giant cell tumor originating from the anterior arch of the fourth rib. The patient, a 21-year-old male, presented with a bulging mass that had been gradually increasing in size over an eight-month period, reaching dimensions of 12 x 8 cm. Despite the noticeable swelling, the patient reported no associated pain or discomfort and denied any history of weight loss or trauma. The absence of chest pain or cardiovascular symptoms distinguished this case from other chest wall pathologies. This report underscores the importance of considering rare entities such as giant cell tumors in the differential diagnosis of chest wall masses, especially in cases where clinical presentation and patient history do not align with more common conditions.
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Affiliation(s)
- Manu Srinivas
- General Surgery, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Prabhat Nichkaode
- Surgery, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Bijay Sharma
- General Surgery, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Shriya Haval
- General Surgery, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
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25
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Callan KT, Anderson A, Kim R, Goldin A, Noori N. Management of Recurrent Giant Cell Tumor of Distal Tibia With Intramedullary Hindfoot Fusion Nail and Trabecular Metal Implant Construct. Cureus 2024; 16:e57922. [PMID: 38725737 PMCID: PMC11081638 DOI: 10.7759/cureus.57922] [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] [Accepted: 04/09/2024] [Indexed: 05/12/2024] Open
Abstract
Reconstruction options for giant cell tumors (GCTs) of bone are limited and challenging due to the amount of structural compromise and the high recurrence rates. This is especially true for GCTs of the foot and ankle, as the area is vital for weight bearing and function. The typical treatment for GCTs is currently excision, curettage, and cementation, although that is not always effective. A 36-year-old otherwise healthy female presented with an original diagnosis of a large aneurysmal bone cyst (ABC) of the distal tibia that had recurred despite two previous attempts at treatment with resection and cementation. She was treated with surgical resection of the lesion, reconstruction, and ankle and subtalar joint arthrodesis with a tibiotalocalcaneal intramedullary nail in combination with a trabecular metal cone. The final pathology of the intraoperative samples was consistent with GCT. Postoperatively, she recovered well, and her imaging was consistent with a successful fusion. This case report provides evidence that tibiotalocalcaneal fusion with a unique combination of hindfoot nail and trabecular metal cone construct in a single procedure is a successful option for the treatment of large, recurrent GCT lesions in the distal tibia.
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Affiliation(s)
- Kylie T Callan
- Orthopedic Surgery, University of California Irvine Medical Center, Orange, USA
| | - Amanda Anderson
- Orthopedic Surgery, University of California Irvine Medical Center, Orange, USA
| | - Ryan Kim
- Orthopedic Surgery, University of California Irvine Medical Center, Orange, USA
| | - Amanda Goldin
- Orthopedic Surgery, University of California Irvine Medical Center, Orange, USA
| | - Naudereh Noori
- Orthopedic Surgery, University of California Irvine Medical Center, Orange, USA
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26
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Yazdi NA, Parviz S, Delazar S, Azadnajafabad S, Aleseidi S, Saffar H, Sadighi N. A case report on pulmonary metastasis of giant cell tumor mimicking arteriovenous malformation. Radiol Case Rep 2024; 19:1078-1082. [PMID: 38229600 PMCID: PMC10789933 DOI: 10.1016/j.radcr.2023.11.075] [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: 05/08/2023] [Revised: 11/07/2023] [Accepted: 11/28/2023] [Indexed: 01/18/2024] Open
Abstract
Giant cell tumor (GCT) is typically a benign tumor of the skeletal system that mainly presents with bone pain. Pulmonary metastasis is one of the distant presentations of GCT in patients who have previously undergone surgical resection of the tumor. Among the various presentations of pulmonary metastasis in GCT, lesions with arteriovenous malformation (AVM) features are rare and have only been reported in a few cases. In this case report, we present the case of a 29-year-old female patient who had previously undergone surgical resection of a GCT in her right lower extremity 4 years ago. The patient was referred to us with progressive dyspnea, and a lesion resembling an AVM was found during radiologic evaluation using chest computed tomography. Pathologic evaluation of the lesion after biopsy revealed that it was a metastasis of GCT presenting with vascular-like features in the lung. This study reports on a very rare occurrence of GCT pulmonary metastasis with an AVM appearance on imaging, highlighting the clinical importance of atypical presentations of pulmonary metastasis in patients with a history of GCT. Appropriate and timely screening and management of such lesions may prevent adverse outcomes such as massive hemorrhage and deterioration of lung function.
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Affiliation(s)
- Niloofar Ayoobi Yazdi
- Department of Radiology, School of Medicine, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital complex (IKHC), Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Parviz
- Department of Radiology, School of Medicine, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital complex (IKHC), Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Delazar
- Department of Radiology, School of Medicine, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital complex (IKHC), Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Azadnajafabad
- Department of Radiology, School of Medicine, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital complex (IKHC), Tehran University of Medical Sciences, Tehran, Iran
| | - Samira Aleseidi
- Heumatology and Internal Medicine, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hana Saffar
- Department of Pathology, Anatomical and Clinical Pathology, Cancer Institute, Imam Khomeini Hospital complex (IKHC), Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Sadighi
- Department of Radiology, School of Medicine, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital complex (IKHC), Tehran University of Medical Sciences, Tehran, Iran
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27
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Miao Z, Xu M, Zheng K, Gong H, Yan N, Chen Q, Yu X. Denosumab combined with precision radiotherapy for recurrent giant cell tumor of the thoracic spine: a case report and literature review. Front Neurol 2024; 14:1308600. [PMID: 38239323 PMCID: PMC10794628 DOI: 10.3389/fneur.2023.1308600] [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: 10/06/2023] [Accepted: 11/28/2023] [Indexed: 01/22/2024] Open
Abstract
Giant cell tumors of the spine have a high recurrence rate owing to their special anatomical site; hence, further treatment after recurrence is very challenging. Achieving effective tumor control and improving the long-term quality of life of the patients are the main treatment purposes to consider for recurrent giant cell tumors of the spine. A patient showing giant cell tumor recurrence of the thoracic spine after curettage received denosumab combined with precision radiotherapy, through which the tumor gained good control and the patient could regain normal functioning. A review of the relevant literature suggested that denosumab combined with radiotherapy is an effective new approach for the treatment of recurrent giant cell tumors of the spine.
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Affiliation(s)
- Zukang Miao
- Department of Orthopedics, The 960th Hospital of the PLA Joint Logistics Support Force, Jinan, China
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Ming Xu
- Department of Orthopedics, The 960th Hospital of the PLA Joint Logistics Support Force, Jinan, China
| | - Kai Zheng
- Department of Orthopedics, The 960th Hospital of the PLA Joint Logistics Support Force, Jinan, China
| | - Hai Gong
- Department of Radiotherapy, The 960th Hospital of the PLA Joint Logistics Support Force, Jinan, China
| | - Ning Yan
- Department of Radiotherapy, The 960th Hospital of the PLA Joint Logistics Support Force, Jinan, China
| | - Qian Chen
- Department of Orthopedics, The 960th Hospital of the PLA Joint Logistics Support Force, Jinan, China
| | - Xiuchun Yu
- Department of Orthopedics, The 960th Hospital of the PLA Joint Logistics Support Force, Jinan, China
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28
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Tschavoll F, Lutteri G, Leinauer B, Mellert K, Möller P, Barth TFE. [Giant cell tumor of bone-an update]. PATHOLOGIE (HEIDELBERG, GERMANY) 2023; 44:215-219. [PMID: 37985483 DOI: 10.1007/s00292-023-01271-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/24/2023] [Indexed: 11/22/2023]
Abstract
In the past few years, numerous new insights have been gained in the field of giant cell tumor of bone (GCTB). On the one hand, the detection of the highly characteristic histone mutation in the H3F3A gene in GCTB is becoming increasingly important in diagnostics in differentiating GCTB from other giant cell-rich lesions of bone as well as for defining rare variants of GCTB without osteoclastic giant cells. On the other hand, the effects of the H3F3A mutation were shown to have an impact on the epigenetic profile of tumor-driving stromal cells, providing new insights into tumorigenesis of GCTB.
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Affiliation(s)
- Felix Tschavoll
- Institut für Pathologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
| | - Gianluca Lutteri
- Institut für Pathologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
| | - Benedikt Leinauer
- Institut für Pathologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
| | - Kevin Mellert
- Institut für Pathologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
| | - Peter Möller
- Institut für Pathologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
| | - Thomas F E Barth
- Institut für Pathologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland.
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29
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Tabarestani TQ, Levine N, Sachs E, Scholl A, Colglazier R, French R, Al-Rohil R, Brigman B, Eward W, Visgauss J. Giant cell tumor of bone in the pediatric population: a retrospective study highlighting cases of metaphyseal only location and increased local recurrence rates in skeletally immature patients. Skeletal Radiol 2023; 52:2399-2408. [PMID: 37154873 DOI: 10.1007/s00256-023-04359-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE To describe the presentation of giant cell tumors (GCT) of the bone in the pediatric population to (1) improve the differential diagnosis of pediatric bone tumors and (2) identify the origin of GCT. Understanding the origin of bone tumors assists in establishing appropriate diagnoses and recommending treatment options. This is particularly important in children, where evaluating the need for invasive procedures is balanced with the desire to avoid overtreatment. GCT have historically been considered epiphyseal lesions with potential metaphyseal extension. Therefore, GCT may be inappropriately excluded from the differential diagnosis of metaphyseal lesions in the skeletally immature. MATERIALS AND METHODS We identified 14 patients from 1981 to 2021 at a single institution who had histologic confirmation of GCT and were less than 18 years old at diagnosis. Patient characteristics, tumor location, surgical treatment, and local recurrence rates were collected. RESULTS AND CONCLUSIONS Ten (71%) patients were female. Eleven (78.6%) were epiphysiometaphyseal (1 epiphyseal, 4 metaphyseal, 6 epiphysiometaphyseal). Five patients had an open adjacent physis, of which three (60%) had tumors confined solely to the metaphysis. Of the five patients with open physis, four (80%) developed local recurrence while only one patient (11%) with a closed physis had local recurrence (p value = 0.0023). Our results illustrate that for the skeletally immature, GCT can (and in our results more commonly did) occur in the metaphyseal location. These findings suggest that GCT should be included in the differential diagnosis of primary metaphyseal-only lesions in the skeletally immature.
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Affiliation(s)
- Troy Q Tabarestani
- Duke University School of Medicine, Duke University Hospital, 40 Duke Medicine Circle, Durham, NC, 27710, USA.
| | - Nicole Levine
- Department of Orthopedics, Duke University Hospital, Durham, NC, USA
| | - Elizabeth Sachs
- Department of Orthopedics, Duke University Hospital, Durham, NC, USA
| | - Ashley Scholl
- Department of Pathology, Duke University Hospital, Durham, NC, USA
| | - Roy Colglazier
- Department of Radiology, Duke University Hospital, Durham, NC, USA
| | - Robert French
- Department of Radiology, Duke University Hospital, Durham, NC, USA
| | - Rami Al-Rohil
- Department of Pathology, Duke University Hospital, Durham, NC, USA
| | - Brian Brigman
- Department of Orthopedics, Duke University Hospital, Durham, NC, USA
| | - William Eward
- Department of Orthopedics, Duke University Hospital, Durham, NC, USA
| | - Julia Visgauss
- Department of Orthopedics, Duke University Hospital, Durham, NC, USA
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30
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Aydin S, Gulmez AO, Cinar HG. Clinic-Sphenoid Bone Giant Cell Bone Tumor. EAR, NOSE & THROAT JOURNAL 2023:1455613231212708. [PMID: 37994622 DOI: 10.1177/01455613231212708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023] Open
Affiliation(s)
- Sonay Aydin
- Erzincan Binali Yıldırım Üniversitesi, Erzincan, Turkey
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31
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Tan X, Zhang Y, Wei D, Yang Y, Xiang F. Denosumab for giant cell tumors of bone from 2010 to 2022: a bibliometric analysis. Clin Exp Med 2023; 23:3053-3075. [PMID: 37103655 DOI: 10.1007/s10238-023-01079-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 04/17/2023] [Indexed: 04/28/2023]
Abstract
Giant cell tumors of the bone (GCTB) are considered moderately malignant bone tumors. Denosumab, as a neoadjuvant therapy, provides new possibilities for treating GCTB. However, even after multiple studies and long-term clinical trials, there are limitations in the treatment process. Research data and Medical Subject Headings terms related to denosumab and GCTB were collected from January 2010 to October 2022 using the Web of Science and MeSH ( https://meshb.nlm.nih.gov ) browsers. These data were imported into CiteSpace and VOSviewer softwares for bibliometric analysis. Overall, 445 publications on denosumab and GCTB were identified. Over the last 12 years, the growth rate of the total number of publications has remained relatively stable. The USA published the highest number of articles (83) and had the highest centrality (0.42). Amgen Inc. and Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) First Ortoped Rizzoli were identified as the most influential institutions. Many authors have made outstanding contributions to this field. Lancet Oncology had the highest journal impact factor (54.433). Local recurrence and drug dosage are current research hotspots, and future development trends will mainly focus on prognostic markers of GCTB and the development of new therapies. Further research is required to analyze denosumab's safety and efficacy and understand its local recurrence of GCTB, to identify the optimal dose. Future progress in this field will likely focus on exploring new diagnostic and recurrence markers to monitor disease progression and examine new therapeutic targets and treatment strategies.
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Affiliation(s)
- Xiaoqi Tan
- Department of Dermatology, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yue Zhang
- Department of Orthopedic, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou, China
| | - Daiqing Wei
- Department of Orthopedic, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou, China
| | - Yunkang Yang
- Department of Orthopedic, Affiliated Hospital of Southwest Medical University, Luzhou, China.
- Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou, China.
| | - Feifan Xiang
- Department of Orthopedic, Affiliated Hospital of Southwest Medical University, Luzhou, China.
- Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou, China.
- Department of Nuclear Medicine, Affiliated Hospital of Southwest Medical University, Luzhou, China.
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China.
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, China.
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.
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32
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Anandan D, Kumar A, Jeyakkani MN, Inja DB, Jaiswal AK. Investigation of Giant Cell Tumor of Bone and Tissue Engineering Approaches for the Treatment of Giant Cell Tumor of Bone. ACS APPLIED BIO MATERIALS 2023; 6:3946-3958. [PMID: 37698377 DOI: 10.1021/acsabm.3c00441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Primary bone tumors such as Ewing sarcoma, osteosarcoma, and chondrosarcoma, secondary bone tumors developed from progressive malignancies, and metastasized bone tumors are more prevalent and studied descriptively through biology and medical research. Less than 0.2% of cancer diagnoses are caused by rare bone-originating tumors, which despite being rare are particularly difficult due to their high death rates and substantial disease burden. A giant cell tumor of bone (GCTB) is an intramurally invasive but rare and benign type of bone tumor, which seldom metastasizes. The most often prescribed medication for GCTB is Denosumab, a RANKL (receptor activator of nuclear factor κB ligand) inhibitor. Because pharmaceutical drug companies rely on two-dimensional and animal models, current approaches for investigating the diverse nature of tumors are insufficient. Cell line based medication effectiveness and toxicity studies cannot predict tumor response to antitumor medicines. It has already been investigated in detail why molecular pathways do not reproduce in vitro, a phenomenon known as flat biology. Due to physiological differences between human beings and animals, animal models do not succeed in identifying side effects of the treatment, emulating metastatic growth, and establishing the link between cancer and the immune system. This review summarizes and discusses GCTB, the disease, its cellular composition, various bone tumor models, and their properties and utilization in research. As a result, this study delves deep into in vitro testing, which is vital for scientists and physicians in various fields, including pharmacology, preclinical investigations, tissue engineering, and regenerative medicine.
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Affiliation(s)
- Dhivyaa Anandan
- Centre for Biomaterials, Cellular and Molecular Theranostics (CBCMT), Vellore Institute of Technology (VIT), Vellore 632014, Tamilnadu, India
| | - Amit Kumar
- Radiation Biology & Health Sciences Division, Bhabha Atomic Research Centre (BARC), Trombay, Mumbai 400085, Maharashtra, India
| | - Manasseh N Jeyakkani
- Department of Orthopaedics, Christian Medical College and Hospital, Vellore 632004, Tamilnadu, India
| | - Dan Barnabas Inja
- Department of Orthopaedics, Christian Medical College and Hospital, Vellore 632004, Tamilnadu, India
| | - Amit Kumar Jaiswal
- Centre for Biomaterials, Cellular and Molecular Theranostics (CBCMT), Vellore Institute of Technology (VIT), Vellore 632014, Tamilnadu, India
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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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34
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Alamoudi AA, Ruprecht A, Gohel A, Katz J. Maxillary Sinusitis Induced by Medication-Related Osteonecrosis of the Jaw. Cureus 2023; 15:e44537. [PMID: 37790069 PMCID: PMC10544693 DOI: 10.7759/cureus.44537] [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] [Accepted: 08/29/2023] [Indexed: 10/05/2023] Open
Abstract
The involvement of maxillary sinuses in patients taking bone-related medications has not been comprehensively considered in the literature, mostly dental. Considering the fact that paranasal sinuses are often captured in dental radiographs, it is incumbent upon dental practitioners to recognize abnormal presentations in the paranasal sinuses to ensure the appropriate management of medication-related osteonecrosis of the jaw (MRONJ). We present a case of a giant cell tumor (GCT) with atypical chronic sinusitis manifestation leading to MRONJ.
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Affiliation(s)
- Abrar A Alamoudi
- Department of Health Sciences, Case Western Reserve University School of Medicine, Cleveland, USA
- Department of Oral Diagnostic Sciences, King Abdulaziz University, Jeddah, SAU
| | - Axel Ruprecht
- Department of Oral Pathology, Radiology, and Medicine, University of Iowa, Iowa City, USA
| | - Anita Gohel
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida Health, Gainesville, USA
| | - Joseph Katz
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida Health, Gainesville, USA
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35
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Ono T, Noguchi R, Yoshimatsu Y, Sin Y, Tsuchiya R, Akiyama T, Kojima N, Toda Y, Sato C, Fukushima S, Yoshida A, Kawai A, Kondo T. Establishment and characterization of two novel patient-derived cell lines from giant cell tumor of bone. Hum Cell 2023; 36:1804-1812. [PMID: 37328637 DOI: 10.1007/s13577-023-00928-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/31/2023] [Indexed: 06/18/2023]
Abstract
Giant cell tumor of bone (GCTB) is a rare bone tumor with osteolytic features, composed of stromal cells with a monotonous appearance, macrophages, and osteoclast-like giant cells. GCTB is commonly associated with a pathogenic mutation in the H3-3A gene. While complete surgical resection is the standard cure for GCTB, it often results in local recurrence and, rarely, metastasis. Thus, an effective multidisciplinary treatment approach is necessary. Although patient-derived cell lines is an essential tool for investigating novel treatment strategies, there are only four GCTB cell lines available in public cell banks. Therefore, this study aimed to establish novel GCTB cell lines and successfully created NCC-GCTB6-C1 and NCC-GCTB7-C1 cell lines from two patients' surgically removed tumor tissues. These cell lines exhibited H3-3A gene mutations, consistent proliferation, and invasive properties. After characterizing their behaviors, we performed high-throughput screening of 214 anti-cancer drugs for NCC-GCTB6-C1 and NCC-GCTB7-C1 and integrated their screening data with those of NCC-GCTB1-C1, NCC-GCTB2-C1, NCC-GCTB3-C1, NCC-GCTB4-C1, and NCC-GCTB5-C1 that we previously established. We identified histone deacetylase inhibitor romidepsin as a possible treatment for GCTB. These findings suggest that NCC-GCTB6-C1 and NCC-GCTB7-C1 could be valuable tools for preclinical and basic research on GCTB.
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Affiliation(s)
- Takuya Ono
- Division of Rare Cancer Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Rei Noguchi
- Division of Rare Cancer Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yuki Yoshimatsu
- Division of Rare Cancer Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- Division of Patient-derived Cancer Model, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
| | - Yooksil Sin
- Division of Rare Cancer Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Ryuto Tsuchiya
- Division of Rare Cancer Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Taro Akiyama
- Division of Rare Cancer Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Naoki Kojima
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yu Toda
- Division of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Chiaki Sato
- Division of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Suguru Fukushima
- Division of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Akihiko Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Akira Kawai
- Division of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Tadashi Kondo
- Division of Rare Cancer Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
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36
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Chobpenthai T, Poosiripinyo T, Warakul C. Reconstruction After En Bloc Resection of a Distal Radius Tumor. An Updated and Concise Review. Orthop Res Rev 2023; 15:151-164. [PMID: 37576613 PMCID: PMC10422987 DOI: 10.2147/orr.s416331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/31/2023] [Indexed: 08/15/2023] Open
Abstract
The distal radius is rarely affected by either primary or metastatic bone cancers. The most frequent tumors of the distal radius are giant cell tumors, which are benign tumors with the propensity to invade. En bloc excision of giant cell tumors of the distal radius achieves a low recurrence rate but compromises the wrist joint, necessitates a significant reconstruction, and has functional consequences. Reconstruction after en bloc resection of a distal radius bone tumor is challenging. Furthermore, orthopedic oncologists disagree on treating such long bone anomalies most effectively. The present article summarizes the various biological and non-biological reconstruction techniques performed after en bloc resection of a distal radius tumor, discusses the advantages and disadvantages of each reconstruction strategy, and summarizes several case studies and case reports.
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Affiliation(s)
- Thanapon Chobpenthai
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand
| | | | - Chawin Warakul
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand
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37
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Kandarkar MM, Jadhav S, Kandarkar SM, Vaidya S. The Rare Occurrence of Giant Cell Tumor of the Proximal Tibia With Pathological Fracture in an Elderly Male: A Case Report. Cureus 2023; 15:e43102. [PMID: 37692754 PMCID: PMC10483092 DOI: 10.7759/cureus.43102] [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: 04/26/2023] [Accepted: 08/07/2023] [Indexed: 09/12/2023] Open
Abstract
Giant cell tumor of the bone (GCTB) is a benign bone tumor that can occasionally progress to malignancy, usually in chronic cases. It is a common benign and aggressive bone tumor that affects patients aged between 20 and 45 years. The most common location is the knee joint. It manifests as a painless or occasionally painful swelling over the affected area. A case of giant cell tumor (GCT) of the proximal tibia in a 72-year-old male is reported here, which was difficult to diagnose as it is rarely found in the geriatric age group. The patient came with a chief complaint of pain and swelling over his left knee for two months with a history of trauma to the knee a couple of times. On clinical examination, the patient had grade 3 tenderness and swelling on the anterolateral aspect of the knee extending toward the proximal tibia. The swelling was well-defined, smooth, firm, and uniform in consistency with dimensions of 15 cm × 12 cm. The swelling was moveable sideways, and the movement of the knee suggested that it was not attached to the underlying bone. As per the age and history of the rapid-growing lesion, we suspected malignancy, but clinical findings were pointing toward benign tumor. X-ray of the affected knee was done, which revealed a soft tissue mass with the involvement of the bone. Magnetic resonance imaging (MRI) of the knee revealed a soft tissue mass with the cortical breach. An open biopsy was done for the confirmation of the diagnosis, which was later reported and confirmed as a giant cell tumor of the proximal tibia. As bone tumor is associated with a cortical breach and pathological fracture, it was classified under Campanacci grade 3, for which an en bloc resection and open reduction and internal fixation with plate osteosynthesis with bone cementing and bone grafting were done followed by knee bending physiotherapy and gradual weight-bearing. Finally, the knee function was improved with pain relief.
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Affiliation(s)
- Madhavi M Kandarkar
- Department of Musculoskeletal Physiotherapy, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Shivshankar Jadhav
- Department of Orthopedic Surgery, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Sanket M Kandarkar
- Department of Orthopedic Surgery, Pravara Institute of Medical Sciences, Ahmednagar, IND
| | - Shubham Vaidya
- Department of Orthopedic Surgery, Lata Mangeshkar Hospital, Nagpur, IND
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38
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Sullivan MH, Townsley SH, Rizzo M, Moran SL, Houdek MT. Management of giant cell tumors of the distal radius. J Orthop 2023; 41:47-56. [PMID: 37324809 PMCID: PMC10267431 DOI: 10.1016/j.jor.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/24/2023] [Accepted: 06/01/2023] [Indexed: 06/17/2023] Open
Abstract
Background The distal radius is the most common location for giant cell tumors (GCT) in the upper extremity. Treatment should balance the goals of maximizing function and minimizing recurrence and other complications. Given the complexity in surgical treatment, various techniques have been described without clear standards of treatment. Objectives The purpose of this review is to provide an overview of evaluation of patients presenting with GCT of the distal radius, discuss management, and provide an updated summary on outcomes of treatment options. Conclusion Surgical treatment should consider tumor Grade, involvement of the articular surface, and patient-specific factors. Options include intralesional curettage and en bloc resection with reconstruction. Within reconstruction techniques, radiocarpal joint preserving and sparing procedures can be considered. Campanacci Grade 1 tumors can be successfully treated with joint preserving procedures, whereas for Campanacci Grade 3 tumors consideration should be given to joint resection to prevent recurrence. Treatment of Campanacci Grade 2 tumors is debated in the literature. Intralesional curettage and adjuvants can successfully treat cases where the articular surface can be preserved, while en-bloc resection should be used in cases where the articular surface cannot undergo aggressive curettage. A variety of reconstructive techniques are used for cases needing resection, with no clear gold standard. Joint sparing procedures preserve motion at the wrist joint, whereas joint sacrificing procedures preserve grip strength. Choice of reconstructive procedure should be made based on patient-specific factors, considering relative functional outcomes, complications, and recurrence rates.
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Affiliation(s)
| | | | - Marco Rizzo
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Steven L. Moran
- Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN, USA
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Zhong J, Xing Y, Zhang G, Hu Y, Ding D, Ge X, Pan Z, Yin Q, Zhang H, Yang Q, Zhang H, Yao W. A systematic review of radiomics in giant cell tumor of bone (GCTB): the potential of analysis on individual radiomics feature for identifying genuine promising imaging biomarkers. J Orthop Surg Res 2023; 18:414. [PMID: 37287036 DOI: 10.1186/s13018-023-03863-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 05/16/2023] [Indexed: 06/09/2023] Open
Abstract
PURPOSE To systematically assess the quality of radiomics research in giant cell tumor of bone (GCTB) and to test the feasibility of analysis at the level of radiomics feature. METHODS We searched PubMed, Embase, Web of Science, China National Knowledge Infrastructure, and Wanfang Data to identify articles of GCTB radiomics until 31 July 2022. The studies were assessed by radiomics quality score (RQS), transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) statement, checklist for artificial intelligence in medical imaging (CLAIM), and modified quality assessment of diagnostic accuracy studies (QUADAS-2) tool. The radiomic features selected for model development were documented. RESULTS Nine articles were included. The average of the ideal percentage of RQS, the TRIPOD adherence rate and the CLAIM adherence rate were 26%, 56%, and 57%, respectively. The risk of bias and applicability concerns were mainly related to the index test. The shortness in external validation and open science were repeatedly emphasized. In GCTB radiomics models, the gray level co-occurrence matrix features (40%), first order features (28%), and gray-level run-length matrix features (18%) were most selected features out of all reported features. However, none of the individual feature has appeared repeatably in multiple studies. It is not possible to meta-analyze radiomics features at present. CONCLUSION The quality of GCTB radiomics studies is suboptimal. The reporting of individual radiomics feature data is encouraged. The analysis at the level of radiomics feature has potential to generate more practicable evidence for translating radiomics into clinical application.
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Affiliation(s)
- Jingyu Zhong
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Yue Xing
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Guangcheng Zhang
- Department of Sports Medicine, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Yangfan Hu
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Defang Ding
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Xiang Ge
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Zhen Pan
- Department of Orthopedics, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Qian Yin
- Department of Pathology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Huizhen Zhang
- Department of Pathology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Qingcheng Yang
- Department of Orthopedics, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Huan Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, 200025, China.
| | - Weiwu Yao
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China.
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40
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Aydin F, Ogul H, Tuncer K, Kantarci M. Bilateral Simultaneous Primary Patellar Giant Cell Tumors. Indian J Orthop 2023; 57:608-610. [PMID: 37006738 PMCID: PMC10050241 DOI: 10.1007/s43465-023-00856-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 02/20/2023] [Indexed: 04/04/2023]
Abstract
Giant cell tumor is a relatively frequent benign bone tumor; that is usually exhibited in the epiphyseo-metaphyseal region of long bones. Computed tomography and magnetic resonance imaging may show cortical thinning and endosteal scalloping of the bone cortex in giant cell tumors. In radiologic imaging, the giant cell tumor of the bone is a heterogeneous mass because it contains many components, such as solitary mass, cystic areas, and bleeding. The occurrence of giant cell bone tumor in the patella is a rare condition and in this letter, we have reported the unusual coexistence of giant cell tumor on the bilateral patella at the same time. To the best of our knowledge, there is no reported case in the literature of bilateral patellar giant cell tumors.
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Affiliation(s)
- Fahri Aydin
- Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Hayri Ogul
- Department of Radiology, Medical Faculty, Duzce University, Arapçiftliği MahallesiSokak, Numara:10, 2901 Duzce, Turkey
| | - Kutsi Tuncer
- Department of Orthopedics and Traumatology, Medical Faculty, Altinbas University, Istanbul, Turkey
| | - Mecit Kantarci
- Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey
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41
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Gong T, Luo Y, Lu M, Wang J, Zhang Y, Wang Y, Tang F, Li Z, Zhou Y, Min L, Tu C. The optimal strategy for 3D-printed uncemented endoprosthesis for the bone defect reconstruction of the distal radius, based on biomechanical analysis and retrospective cohort study. J Surg Oncol 2023; 127:1043-1053. [PMID: 36825890 DOI: 10.1002/jso.27215] [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: 12/06/2022] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 02/25/2023]
Abstract
INTRODUCTION Prosthetic reconstruction after resecting giant cell tumor of bone (GCTB) of the distal radius has been proposed. However, this is generally associated with various complications. To improve the functional outcomes, we designed a three-dimensional (3D)-printed uncemented endoprosthesis. Meanwhile, using finite-element analysis and clinical observation, an optimization strategy was explored. MATERIALS AND METHODS We retrospectively analyzed patients with Campanacci III or recurrent GCTB of the distal radius who underwent 3D-printed uncemented endoprosthesis reconstruction. Clinically, according to the different palmar tilts of the endoprosthesis, patients were divided into the biological angle (BA) group and the zero-degree (ZD) group. We recorded and evaluated the differences in functional outcomes and complications between the two groups. Biomechanically, four 3D finite-element models (normal and customized endoprostheses with three different implemented palmar tilts) were developed. RESULTS We analyzed 22 patients (12 males and 10 females). The median follow-up period was 60 (range, 19-82) months. Of the 22 patients, 11 patients were included in the BA group and the remaining 11 patients were in the ZD group. Both groups showed no significant differences in the range of motion, Mayo score, and disabilities of the arm, shoulder, and hand scores postoperatively. The subluxation rate was significantly lower in the ZD group than in the BA group. The biomechanical results showed similar stress and displacement distribution patterns in the normal and prosthetic reconstruction models. Additionally, the endoprosthesis with 0° palmar tilt showed better biomechanical performance. CONCLUSION 3D-printed uncemented endoprosthesis provides acceptable midterm outcomes in patients undergoing distal radius reconstruction. Optimizing the design by decreasing the palmar tilt may be beneficial for decreasing the risk of wrist joint subluxation.
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Affiliation(s)
- Taojun Gong
- Department of Orthopedics, West China Hospital, Orthopaedic Research Institute , Sichuan University, Chengdu, People's Republic of China.,Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Yi Luo
- Department of Orthopedics, West China Hospital, Orthopaedic Research Institute , Sichuan University, Chengdu, People's Republic of China.,Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Minxun Lu
- Department of Orthopedics, West China Hospital, Orthopaedic Research Institute , Sichuan University, Chengdu, People's Republic of China.,Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Jie Wang
- Department of Orthopedics, West China Hospital, Orthopaedic Research Institute , Sichuan University, Chengdu, People's Republic of China.,Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Yuqi Zhang
- Department of Orthopedics, West China Hospital, Orthopaedic Research Institute , Sichuan University, Chengdu, People's Republic of China.,Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Yitian Wang
- Department of Orthopedics, West China Hospital, Orthopaedic Research Institute , Sichuan University, Chengdu, People's Republic of China.,Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Fan Tang
- Department of Orthopedics, West China Hospital, Orthopaedic Research Institute , Sichuan University, Chengdu, People's Republic of China.,Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Zhuangzhuang Li
- Department of Orthopedics, West China Hospital, Orthopaedic Research Institute , Sichuan University, Chengdu, People's Republic of China.,Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Yong Zhou
- Department of Orthopedics, West China Hospital, Orthopaedic Research Institute , Sichuan University, Chengdu, People's Republic of China.,Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Li Min
- Department of Orthopedics, West China Hospital, Orthopaedic Research Institute , Sichuan University, Chengdu, People's Republic of China.,Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Chongqi Tu
- Department of Orthopedics, West China Hospital, Orthopaedic Research Institute , Sichuan University, Chengdu, People's Republic of China.,Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, Chengdu, Sichuan, People's Republic of China
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Luo Y, Xiu P, Chen H, Zeng J, Song Y, Li T. Denosumab salvage therapy in an 11-year-old boy with locally recurrent unresectable giant cell tumor of the lumbar spine after surgery. Neurochirurgie 2023; 69:101427. [PMID: 36828057 DOI: 10.1016/j.neuchi.2023.101427] [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: 08/25/2022] [Revised: 10/31/2022] [Accepted: 11/30/2022] [Indexed: 02/24/2023]
Abstract
Giant cell tumors (GCTs) of the bone are locally aggressive primary bone tumors with a benign character. Spinal involvement is rare which accounts for approximately 5% of all primary bone tumors and it is quite rare in the lumbar spine. An 11-year-old boy patient presented with pain of low back and bilateral low extremities. Lumbar CT and MRI revealed a lytic lesion of the L4 vertebra corpus. The patient earned remarkable and timely recovery with 2 surgical interventions and the use of denosumab. Surgical resection for GCTs is still preferable as the initial treatment, denosumab should be utilized after tumor resection whether based on the purpose of prevention or treatment of tumor recurrence.
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Affiliation(s)
- Y Luo
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, China
| | - P Xiu
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, China
| | - H Chen
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, China
| | - J Zeng
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, China
| | - Y Song
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, China
| | - T Li
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, China.
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CT-Guided RFA for Management of Surgical Relapses of Giant Cell Tumour of Bone. Cardiovasc Intervent Radiol 2023; 46:508-511. [PMID: 36823381 DOI: 10.1007/s00270-023-03382-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 01/29/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVES This retrospective study describes a pilot experience in CT-guided RadioFrequency Ablation (RFA) treatment of 5 Giant Cell Tumour of the bone (GCT) recurrences after surgery. METHODS After biopsy to confirm the diagnosis of GCT recurrences, all patients were treated with RFA in a single session. A close follow-up was scheduled with contrast-enhanced MRI starting 1 months after treatment. RESULTS Five lesions were treated in 5 patients. The length of the observation period was between 4 and 100 months. One lesion relapsed 4 months after the RFA treatment, and the patient underwent a second surgical treatment which included the en-block resection and prosthetic implant. No complications were recorded. CONCLUSIONS The management of GCT relapses with RFA could be an interesting and innovative field. However, the results of this limited series need to be confirmed by further investigations of larger patient cohorts.
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Saeed J, Shamsi Z, Ahmed KS, Umer M. Role of Denosumab in the Management of Giant Cell Tumor, a Cross Sectional Study. INTERNATIONAL JOURNAL OF SURGERY: ONCOLOGY 2023. [DOI: 10.29337/ijsonco.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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45
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Cornellas L, Saez de Gordoa K, Bartolome A, Larque AB, Tomas X. Talar metastasis of mucinous lung adenocarcinoma with fluid-fluid levels: a rare presentation mimicking a benign tumor. Skeletal Radiol 2023; 52:257-262. [PMID: 35869327 DOI: 10.1007/s00256-022-04123-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 02/02/2023]
Abstract
The differential diagnosis of bone tumors in the talus is broad and includes both benign and malignant conditions. Metastases, although very rare, are one of these conditions. The typical nonspecific clinical and radiological presentations of metastases are a diagnostic challenge, and a high level of suspicion is needed in order to perform an adequate diagnostic approach. Moreover, they can present with features which have classically been associated with benign conditions such as fluid-fluid levels. We present a rare case of talar metastasis of a mucinous pulmonary adenocarcinoma that presented with fluid-fluid levels and was initially misdiagnosed as a giant-cell tumor with areas of secondary aneurysmal bone cyst transformation.
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Affiliation(s)
- Lluria Cornellas
- Radiology Dpt. Hospital Clínic (UB), Villarroel 170, 08036, Barcelona, Spain.
| | | | - Alvaro Bartolome
- Radiology Dpt. Hospital Clínic (UB), Villarroel 170, 08036, Barcelona, Spain
| | - Ana Belen Larque
- Pathology Dpt. Hospital Clínic (UB), Villarroel 170, 08036, Barcelona, Spain
| | - Xavier Tomas
- Radiology Dpt. Hospital Clínic (UB), Villarroel 170, 08036, Barcelona, Spain
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46
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Belluomo R, Khodaei A, Amin Yavari S. Additively manufactured Bi-functionalized bioceramics for reconstruction of bone tumor defects. Acta Biomater 2023; 156:234-249. [PMID: 36028198 DOI: 10.1016/j.actbio.2022.08.042] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 02/08/2023]
Abstract
Bone tissue exhibits critical factors for metastatic cancer cells and represents an extremely pleasant spot for further growth of tumors. The number of metastatic bone lesions and primary tumors that arise directly from cells comprised in the bone milieu is constantly increasing. Bioceramics have recently received significant attention in bone tissue engineering and local drug delivery applications. Additionally, additive manufacturing of bioceramics offers unprecedented advantages including the possibilities to fill irregular voids after the resection and fabricate patient-specific implants. Herein, we investigated the recent advances in additively manufactured bioceramics and ceramic-based composites that were used in the local bone tumor treatment and reconstruction of bone tumor defects. Furthermore, it has been extensively explained how to bi-functionalize ceramics-based biomaterials and what current limitations impede their clinical application. We have also discussed the importance of further development into ceramic-based biomaterials and molecular biology of bone tumors to: (1) discover new potential therapeutic targets to enhance conventional therapies, (2) local delivering of bio-molecular agents in a customized and "smart" way, and (3) accomplish a complete elimination of tumor cells in order to prevent tumor recurrence formation. We emphasized that by developing the research focus on the introduction of novel 3D-printed bioceramics with unique properties such as stimuli responsiveness, it will be possible to fabricate smart bioceramics that promote bone regeneration while minimizing the side-effects and effectively eradicate bone tumors while promoting bone regeneration. In fact, by combining all these therapeutic strategies and additive manufacturing, it is likely to provide personalized tumor-targeting therapies for cancer patients in the foreseeable future. STATEMENT OF SIGNIFICANCE: To increase the survival rates of cancer patients, different strategies such as surgery, reconstruction, chemotherapy, radiotherapy, etc have proven to be essential. Nonetheless, these therapeutic protocols have reached a plateau in their effectiveness due to limitations including drug resistance, tumor recurrence after surgery, toxic side-effects, and impaired bone regeneration following tumor resection. Hence, novel approaches to specifically and locally attack cancer cells, while also regenerating the damaged bony tissue, have being developed in the past years. This review sheds light to the novel approaches that enhance local bone tumor therapy and reconstruction procedures by combining additive manufacturing of ceramic biomaterials and other polymers, bioactive molecules, nanoparticles to affect bone tumor functions, metabolism, and microenvironment.
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Affiliation(s)
- Ruggero Belluomo
- Department of Orthopedics, University Medical Center Utrecht, Utrecht 3508GA, the Netherlands
| | - Azin Khodaei
- Department of Orthopedics, University Medical Center Utrecht, Utrecht 3508GA, the Netherlands
| | - Saber Amin Yavari
- Department of Orthopedics, University Medical Center Utrecht, Utrecht 3508GA, the Netherlands; Regenerative Medicine Utrecht, Utrecht University, Utrecht, the Netherlands.
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Muacevic A, Adler JR, Federer A, Lindeque B. Giant Cell Tumor of the Wrist After Fracture Osteosynthesis: A Case Report. Cureus 2023; 15:e34110. [PMID: 36843756 PMCID: PMC9946760 DOI: 10.7759/cureus.34110] [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] [Accepted: 01/23/2023] [Indexed: 01/25/2023] Open
Abstract
A 60-year-old female sustained a distal radius fracture and underwent open reduction internal fixation with a volar locking plate. The patient had an uneventful recovery until four months postoperatively when the patient clinically regressed, and an expansile, radiolucent metaepiphyseal lesion was found. Further workup revealed this was a giant cell tumor of bone (GCTB). Definitive management consisted of extensive curettage, cryoablation, and cementation of the lesion, and the hardware was left intact. The current case presents an uncommon presentation of GCTB. The case illuminates the importance of thorough scrutiny of postoperative radiographs when clinical improvement plateaus or regresses and the need to pursue additional workup when the clinical course is atypical. The authors query the possibility of a sub-radiological presentation of GCTB.
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Affiliation(s)
- Alexander Muacevic
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - John R Adler
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, USA
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Xu H, Li Y, Wang T, Liu W, Ma K, Yang Y, Huang Z, Li C, Niu X. A Retrospective Observational Study on Disease Characteristics and Treatment Patterns of Giant Cell Tumor of the Bone in China. J Cancer Epidemiol 2023; 2023:5468291. [PMID: 37153026 PMCID: PMC10162870 DOI: 10.1155/2023/5468291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 03/28/2023] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Aims Giant cell tumor of the bone (GCTB) is associated with considerable morbidity. As GCTB epidemiological data for China are limited, this study is aimed at describing the disease characteristics of GCTB in China and establishing the historical context for its treatment before recent advances in treatment options. Methods The disease characteristics, treatment patterns, and local GCTB recurrence rate after primary surgery for GCTB were evaluated in this single-center, retrospective, noninterventional, observational study of patients treated for GCTB at Ji Shui Tan Hospital, Beijing, from 2009 to 2016 based on medical chart review. Patients with unmet need were defined as those whose surgical treatment was difficult or who had to undergo high-morbidity surgery. Results Among the 668 patients with a primary GCTB diagnosis, 578 (86.5%) of target lesions were in the extremities, and 89 (13.3%) were in the pelvic or axial bone. Of these, 173 (25.9%) were characterized as having an unmet need. Almost all GCTB patients received surgical treatment at both primary diagnosis (666/668 (99.7%)) and last disease recurrence (196/200 (98.0%)). Additionally, about one-third of patients received nonsurgical treatment at primary diagnosis (205/668 (30.7%)) and disease recurrence (67/200 (33.5%)), with neoadjuvant therapy being the most common treatment. The rate of high-morbidity surgery increased for recurrent disease (65/200 (32.5%)) compared with primary diagnosis (111/668 (16.6%)). The 2-year cumulative incidence of postoperative disease recurrence was 29.2%, in line with rates observed in prior studies. Conclusion As many patients with primary and recurrent disease received high-morbidity surgery, more effective treatments are needed.
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Affiliation(s)
- Hairong Xu
- Department of Orthopaedic Oncology Surgery, Beijing Ji Shui Tan Hospital, Beijing, China
| | - Yuan Li
- Department of Orthopaedic Oncology Surgery, Beijing Ji Shui Tan Hospital, Beijing, China
| | - Tao Wang
- Department of Orthopaedic Oncology Surgery, Beijing Ji Shui Tan Hospital, Beijing, China
| | - Weifeng Liu
- Department of Orthopaedic Oncology Surgery, Beijing Ji Shui Tan Hospital, Beijing, China
| | - Ke Ma
- Department of Orthopaedic Oncology Surgery, Beijing Ji Shui Tan Hospital, Beijing, China
| | - Yongkun Yang
- Department of Orthopaedic Oncology Surgery, Beijing Ji Shui Tan Hospital, Beijing, China
| | - Zhen Huang
- Department of Orthopaedic Oncology Surgery, Beijing Ji Shui Tan Hospital, Beijing, China
| | | | - Xiaohui Niu
- Department of Orthopaedic Oncology Surgery, Beijing Ji Shui Tan Hospital, Beijing, China
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Giant Cell Tumor of Lumbar Vertebrae on MR and 18F- FDG PET/CT: A Case Report and Literature Review. J Belg Soc Radiol 2023; 107:17. [PMID: 36911178 PMCID: PMC10000323 DOI: 10.5334/jbsr.3012] [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: 11/12/2022] [Accepted: 02/15/2023] [Indexed: 03/08/2023] Open
Abstract
Teaching Point: Giant cell tumor of bone may show a moderate to high FDG uptake, and attention should be paid to differentiate from malignant tumors.
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Hess MC, Kafchinski L, Ransom E. Giant Cell Tumor of the Distal Radius: A Review. Orthop Clin North Am 2023; 54:75-88. [PMID: 36402513 DOI: 10.1016/j.ocl.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Giant cell tumor of the distal radius presents a significant challenge in management due to high risk of recurrence and potential loss of function. Shared decision-making guides management, particularly for more advanced lesions. Intralesional curettage can optimize wrist function but at the cost of a higher recurrence risk. Wide resection decreases local recurrence but has higher complication rates regardless of reconstruction method. No functional difference exists between motion-preserving procedures and arthrodesis; therefore, patients should be clearly informed of the risks and benefits of each treatment option.
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Affiliation(s)
- Matthew C Hess
- Department of Orthopaedic Surgery, University of Alabama-Birmingham, 1313 13th Street South, Birmingham, AL 35205, USA.
| | - Lisa Kafchinski
- Department of Orthopaedic Surgery, University of Alabama-Birmingham, 1313 13th Street South, Birmingham, AL 35205, USA
| | - Erin Ransom
- Department of Orthopaedic Surgery, University of Alabama-Birmingham, 1313 13th Street South, Birmingham, AL 35205, USA
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