Denosumab-treated giant cell tumor of bone. Its histologic spectrum and potential diagnostic pitfalls

Roitman, Pablo; Jauk, Federico; Farfalli, Germán L.; Albergo, José I.; Aponte-Tinao, Luis A.

doi:10.1016/j.humpath.2017.02.008

Cited by 45 publications

(46 citation statements)

References 18 publications

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“…Previous histopathological studies, as well as ours, demonstrated woven bone formation in GCTB after denosumab therapy . This dramatic histological change can be explained by the interaction between the tumour cells and osteoclastic cells in the denosumab‐modified microenvironment.…”

Section: Discussionsupporting

confidence: 71%

“…That study also revealed a striking alteration in the histology of GCTB that manifested as a marked decrease in the number of giant cells and an increase in dense fibro‐osseous tissue and/or new bone . These histopathological findings were confirmed by other groups, and differential diagnoses of denosumab‐treated GCTB versus tumours of similar histology (such as osteosarcoma and fibrous dysplasia) have been examined …”

Section: Introductionsupporting

confidence: 56%

“…Previous histopathological studies, as well as ours, demonstrated woven bone formation in GCTB after denosumab therapy. [4][5][6] This dramatic histological change can be explained by the interaction between the tumour cells and osteoclastic cells in the denosumab-modified microenvironment. Under physiological conditions, osteoblastic bone formation is induced by osteoclasts via coupling factors in the context of bone remodelling.…”

Section: Discussionmentioning

confidence: 99%

“…3 These histopathological findings were confirmed by other groups, and differential diagnoses of denosumab-treated GCTB versus tumours of similar histology (such as osteosarcoma and fibrous dysplasia) have been examined. [4][5][6] In addition to the effect of targeting RANKLmediated signalling with denosumab, the genetic abnormalities in GCTB are also highly noteworthy. Behjati et al identified a recurrent mutation of the H3 histone family member 3A gene (H3F3A); this gene encodes histone H3.3, which is a variant of histone H3 that maintains nucleosome structure.…”

Section: Introductionmentioning

confidence: 99%

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Giant cell tumours of bone treated with denosumab: histological, immunohistochemical and H3F3A mutation analyses

et al. 2018

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Section: Discussionsupporting

confidence: 71%

Section: Introductionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Giant cell tumours of bone treated with denosumab: histological, immunohistochemical and H3F3A mutation analyses

et al. 2018

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“…The response to denosumab therapy can be seen both histologically and radiographically. GCTb tissue analysis after denosumab therapy has shown to decrease both giant cell tumor numbers and underlying stromal cell proliferation [28,29]. Post-denosumab therapy radiographic findings include decreased tumor size, bone lysis, and standardized fluorodeoxyglucose uptake [30].…”

Section: Discussionmentioning

confidence: 99%

Sphenoid Sinus Giant Cell Tumor: A Case Report and Literature Review

Pousti

Andera

Haugen

2020

ORL

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We describe a 27-year-old female with a giant cell tumor of her sphenoid sinus, presenting with nasal obstruction and cranial neuropathies. Both the surgical and subsequent medical management are reviewed. Additionally, we review the overall presentation, pathophysiology, and management of giant cell tumors of the skull base. Current treatment recommendations are presented.A 27-year-old female presented to our institution with a 1-month history of retro-orbital headache, neck pain, nasal obstruction, and blurred vision. CT head identified a sphenoid mass with extension into the sella, clivus, and ethmoid sinuses ( Fig. 1). MRI outlined a clival mass extending into the sphenoid sinus and cavernous sinus with a mass effect on the contents of the sella turcica (Fig. 2). An endoscopic endonasal biopsy was performed with pathology consistent with GCTb (Fig. 3).The patient then presented to the emergency department 5 days later with new-onset diplopia of the right eye, nasal drainage, and worsening headache. She was found to have a right-sided cranial nerve VI palsy. MRI showed invasion into the cavernous sinus with encroachment on the optic chiasm and internal carotid arteries bilaterally. ConclusionGiant cell tumors of the skull base are rare, benign, and locally aggressive, with high recurrence rates. The age of presentation is usually between 20 and 40 years with a predominance in females. The presenting clinical symptoms vary widely depending on tumor location. Hearing loss, headache, tinnitus, and dysfunction of the cranial nerves are the usual modes of presentation in skull base involvement. Surgical excision remains the treatment of choice, yet due to the possibility of incomplete resection and high recurrence rates, adjuvant therapy with denosumab may be necessary to improve local control. Our report, in combination with previous reports, provides evidence to support this as a potential new standard of care.

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Denosumab in Giant Cell Tumors of Bone

Parry

Grimer

2021

Evidence‐Based Orthopedics

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Denosumab-treated giant cell tumor of bone. Its histologic spectrum and potential diagnostic pitfalls

Cited by 45 publications

References 18 publications

Giant cell tumours of bone treated with denosumab: histological, immunohistochemical and H3F3A mutation analyses

Giant cell tumours of bone treated with denosumab: histological, immunohistochemical and H3F3A mutation analyses

Sphenoid Sinus Giant Cell Tumor: A Case Report and Literature Review

Denosumab in Giant Cell Tumors of Bone

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