Pulmonary metastasis of giant cell tumour: a retrospective study of three hundred and ten cases

Wang, Jun; Liu, Xingyu; Yang, Yi; Yang, Ru; Tang, Xiaodong; Yan, Taiqiang; Guo, Wei

doi:10.1007/s00264-020-04907-0

Cited by 19 publications

(14 citation statements)

References 33 publications

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“…Lung metastases occur in 1-9% of patients with GCTBs [5][6][7][8][9]. Distal radius [8,9], Campanacci stage 3 [114], and repeated local recurrences [114][115][116][117][118][119] have been associated with lung metastases. A recent study including patients with GCTB of the extremities reported similar lung metastasis rates between the group undergoing surgery and preoperative and postoperative denosumab therapy and the group undergoing surgery alone (3.3% (1 of 30 patients) vs. 4.7% (18 of 381 patients)) [115].…”

Section: Lung Metastasismentioning

confidence: 99%

Current Concepts in the Treatment of Giant Cell Tumors of Bone

Tsukamoto

Mavrogenis

Kido

et al. 2021

Cancers

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The 2020 World Health Organization classification defined giant cell tumors of bone (GCTBs) as intermediate malignant tumors. Since the mutated H3F3A was found to be a specific marker for GCTB, it has become very useful in diagnosing GCTB. Curettage is the most common treatment for GCTBs. Preoperative administration of denosumab makes curettage difficult and increases the risk of local recurrence. Curettage is recommended to achieve good functional outcomes, even for local recurrence. For pathological fractures, joints should be preserved as much as possible and curettage should be attempted. Preoperative administration of denosumab for pelvic and spinal GCTBs reduces extraosseous lesions, hardens the tumor, and facilitates en bloc resection. Nerve-sparing surgery after embolization is a possible treatment for sacral GCTBS. Denosumab therapy with or without embolization is indicated for inoperable pelvic, spinal, and sacral GCTBs. It is recommended to first observe lung metastases, then administer denosumab for growing lesions. Radiotherapy is associated with a risk of malignant transformation and should be limited to cases where surgery is impossible and denosumab, zoledronic acid, or embolization is not available. Local recurrence after 2 years or more should be indicative of malignant transformation. This review summarizes the treatment approaches for non-malignant and malignant GCTBs.

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Section: Lung Metastasismentioning

confidence: 99%

Current Concepts in the Treatment of Giant Cell Tumors of Bone

Tsukamoto

Mavrogenis

Kido

et al. 2021

Cancers

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“…all the patients developed metastasis after suffering from local recurrence. A recent study conducted by Wang et al 32 found 18 (5.8%) cases of pulmonary metastasis in 310 patients with GCT. Local recurrence was an independent risk factor for pulmonary metastasis; 16 (88.9%) patients had a history of local recurrence.…”

Section: Discussionmentioning

confidence: 96%

“…Local recurrence was an independent risk factor for pulmonary metastasis; 16 (88.9%) patients had a history of local recurrence. 32 Local recurrence can be avoided by adequate curettage of the tumor. When facing recurrent tumors, wide resection of the tumor instead of curettage would provide local tumor control.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and oncological outcomes of pulmonary metastasis in patients with giant cell tumor of bone

Ebeid

Badr

Mesregah

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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Background: Giant cell tumor (GCT) of bone has a rare potential for metastatic spread. This study aimed at evaluating the incidence of chest metastases in GCT and their oncological outcome and identifying possible risk factors. Methods: Medical records of 466 (313 de novo and 153 recurrent) patients with primary GCT of bone were retrospectively reviewed. Fifteen (3.2%) patients developed chest metastasis. Time from diagnosis of the primary bone lesion to the diagnosis of metastasis, treatment modalities of metastasis, and the course of treatment were revised. The functional outcome was evaluated using the Musculoskeletal Tumor Society (MSTS) scoring system, and postoperative complications were recorded. Results: This study included 7 males and 8 females with a mean age of 27.3 ± 7.9 years. The most common site of the primary tumor was the distal femur. All fifteen patients were recurrent cases. The mean follow-up period was 67.7 ± 33.2 months. Chest metastasis was diagnosed after a mean time of 28.1 ± 28.9 months from the initial diagnosis of the bone lesion. One patient died of disease (DOD) 18 months after the surgical intervention. The incidence of chest metastasis in recurrent cases was 9.8%, while de novo cases did not develop chest metastasis, P < 0.001. Previous curettage was associated with a higher incidence of chest metastasis (14.6%) compared to previous resection (4.2%), P ¼ 0.03. Conclusions: Chest metastasis following GCT of bone is rare. Risk factors include recurrent cases, especially following previous curettage. Patients have a good prognosis and a low mortality rate.

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“…Although GCTB is classified as a benign tumor, lung metastasis rates vary from 1%−21.1%. 3 , 11 Since the incidence of pulmonary metastasis of GCTB is rather rare, there is no definite protocol for the treatment of metastatic GCTB. According to the National Comprehensive Cancer Network guidelines, surgical excision is the mainstay of the treatment for patients with resectable metastases.…”

Section: Discussionmentioning

confidence: 99%

“… 1 It typically occurs between the ages of 20−40, is generally more common in females, 2 and has a high tendency for local recurrence. 1 , 3 Pulmonary metastasis rarely occurs, affecting only 1%−3.9% of patients without local recurrence and 6%−21.1% of patients with local recurrence. The overall mortality rate of these patients varies widely from 0 to 23%.…”

Section: Introductionmentioning

confidence: 99%

Multiple Pulmonary Metastases of Recurrent Giant Cell Tumor of Bone with Expression of VEGFR-2 Successfully Controlled by Denosumab and Apatinib: A Case Report and Literature Review

Gong¹,

Luo²,

Wang³

et al. 2021

CMAR

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Giant cell tumor of bone (GCTB) is a rare, benign, but locally aggressive bone tumor. It has a high tendency for local recurrence, which may increase the incidence of lung metastasis. Currently, an optimal treatment strategy has not been established because of the rarity of pulmonary metastatic GCTB. Denosumab is the preferred regimen for unresectable metastatic lesions; however, there are no alternative treatment options when patients are resistant to denosumab. Apatinib is a small-molecule tyrosine kinase inhibitor that selectively competes for the vascular endothelial growth factor receptor 2 (VEGFR-2) ATP binding site, and several studies have analyzed the effectiveness of apatinib in advanced or metastatic tumors. However, there is no report of apatinib as an anti-angiogenesis therapy for pulmonary metastatic GCTB to date. Here, we present a case of a 26-year-old female who was diagnosed with recurrent and pulmonary metastatic GCTB. Immunohistochemical (IHC) staining indicated that the tumor cells were positive for VEGFR-2. Denosumab was administered to control the metastases; nevertheless, disease progression was confirmed after four months of treatment. Given the IHC results and rapid disease progression, apatinib was added to the treatment strategy. After 42 months of treatment, the patient showed noticeable symptomatic improvement and considerable tumor shrinkage.

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Pulmonary metastasis of giant cell tumour: a retrospective study of three hundred and ten cases

Cited by 19 publications

References 33 publications

Current Concepts in the Treatment of Giant Cell Tumors of Bone

Current Concepts in the Treatment of Giant Cell Tumors of Bone

Risk factors and oncological outcomes of pulmonary metastasis in patients with giant cell tumor of bone

Multiple Pulmonary Metastases of Recurrent Giant Cell Tumor of Bone with Expression of VEGFR-2 Successfully Controlled by Denosumab and Apatinib: A Case Report and Literature Review

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