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'Salvage Treatment' of Aggressive Giant Cell Tumor of Bones with Denosumab.

Authors
  • Vaishya, Raju1
  • Agarwal, Amit Kumar1
  • Vijay, Vipul2
  • 1 Orthopaedics, indraprastha Apollo Hospital.
  • 2 Orthopaedics, Indraprastha Apollo Hospital.
Type
Published Article
Journal
Cureus
Publisher
Cureus, Inc.
Publication Date
Jul 01, 2015
Volume
7
Issue
7
Identifiers
DOI: 10.7759/cureus.291
PMID: 26251767
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Giant cell tumor of the bone (GCTB) presents as a lytic lesion of epiphyseometaphyseal regions of the long bones usually during the second to the fourth decade with female predilection. Histologically, they are formed of neoplastic mononuclear cells with a higher receptor activator of nuclear factor kappa-B ligand (RANKL) expression responsible for the aggressive osteolytic nature of the tumour. RANKL helps in the formation and functioning of osteoclasts. A newer molecule, Denosumab, is a monoclonal antibody directed against RANKL and thus prevents the formation and function of osteoclasts. Management of refractory, multicentric, recurrent, or metastatic GCTB remains challenging as achieving a tumor-free margin surgically is not always possible. Denosumab may play a crucial role, especially in the management of such difficult lesions. We present three cases of locally aggressive GCTB (involving proximal humerus, sacrum, and proximal femur) that were treated and responded very well to Denosumab therapy.

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