Treatment and outcome of malignant giant cell tumor in the spine

Yin, Huabin; Cheng, Mo; Li, Bo; Li, Binbin; Wang, Peng; Meng, Tong; Wang, Jing; Wang, Zhou; Yan, Wangjun; Xiao, Jianru

doi:10.1007/s11060-015-1835-9

Cited by 22 publications

(26 citation statements)

References 38 publications

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“…However, most of these tumours are benign, and only a small number of GCTs (1-2%) may undergo malignant transformation, leading to a poor prognosis. According to the previous reports, GCTs can transform into fibrosarcoma, osteosarcoma, malignant fibrous histiocytoma, undifferentiated high-grade pleomorphic sarcoma, and undifferentiated sarcoma [4,18,19]. GCTs of the bone appear as expansive lytic lesions with non-sclerosing, well-defined edges on radiography, whereas CT and MRI provide information on the extent of the bone, bone marrow, and surrounding soft tissue involvement.…”

Section: Discussionmentioning

confidence: 99%

“…It typically originates in the metaphyseal ends of long bones and rarely in the spine [1][2][3]. Approximately 1.4-9.4% of GCTs occur in the vertebrae above the sacrum in patients aged 20-40 years, and they more commonly occur in women than in men [4]. Although GCT is predominantly considered as a benign lesion, it may change from an indolent and static tumour to a locally invasive lesion with extensive bone destruction, cortical breakthroughs, and soft tissue expansion [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Surgical treatment is the foundational treatment strategy for spinal GCT of the bone with the aim of preserving functionality, relieving pain, controlling local recurrence, and promoting prolonged survival [4]. Although intralesional curettage has been established as the preferred treatment for most GCTs, recommendations on treating tumours with rare localisations, such as in the spine or the sacrum, are still unclear [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Recurrent giant cell tumour of the thoracic spine managed by total en bloc spondylectomy and denosumab therapy: a case report

Duan

Sheng

Deng

et al. 2020

BMC Musculoskelet Disord

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Background: Giant cell tumour (GCT) of the bone is a rare, invasive benign bone tumour, which typically originates in the metaphyseal ends of long bones and rarely in the spine. Here, we report a rare case of recurrent GCT of the thoracic vertebra, which was managed by three-level total en bloc spondylectomy (TES) after denosumab therapy. Case presentation: A 50-year-old woman presented with a 2-month history of progressive lower back pain. Magnetic resonance imaging revealed destruction of the T11 vertebra and a soft tissue mass. The patient underwent tumour resection. Computed tomography at the 2-year follow-up revealed relapse of the resected tumour, which had spread to the T12 vertebral body. Subsequently, denosumab therapy was administered to the patient for 1 year. The growth of the tumour was controlled, and its boundary line was clear. Thereafter, TES for the T10-T12 vertebrae was performed, and spinal reconstruction was completed through a one-stage single posterior approach. The patient's condition improved postoperatively, and no evidence of recurrence of GCT of the bone or spinal deformity was observed at the 32-month follow-up. Conclusions: Denosumab therapy contributed to tumour regression. Three-level TES may be an effective and feasible strategy for managing large recurrent GCTs of the spine after denosumab therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Recurrent giant cell tumour of the thoracic spine managed by total en bloc spondylectomy and denosumab therapy: a case report

Duan

Sheng

Deng

et al. 2020

BMC Musculoskelet Disord

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“…The term "malignancy in GCTB" is used by the World Health Organization to describe such tumors, which show malignant potential and can completely transform into malignant tumors [25,26]. Currently, preoperative prediction and postoperative monitoring of GCTB patient prognosis are limited and mostly rely on patients' general information, radiological features, treatment history, and tumor pathological reports [1,4,5].…”

Section: Discussionmentioning

confidence: 99%

Stromal Cell-Derived CCL20 Promotes Tumor Progression and Osteolysis in Giant Cell Tumor of Bone

Zhao

Wang

Tang

et al. 2018

Cell Physiol Biochem

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Background/Aims: Giant cell tumor of bone (GCTB), one of the most common primary bone tumors, leads to extensive bone destruction. However, the mechanisms underlying GCTB progression remain elusive and prognostic factors and treatment targets are required. In the current study, we explored the function of the chemokine family member CCL20 in GCTB progression. Methods: We explored the expression of CCL20 in stromal cells (GCTSCs) using microarray. Clinical analyses of the role of CCL20 in tumor progression were performed based on the patient cohort of our institution. The role of CCL20 in tumor proliferation was evaluated by MTS assay, migration ability was measured by a Transwell assay, and osteoclastogenesis was induced by CCL20 or GCTSC-conditioned medium. Quantitative PCR and western blot were used to measure the expression levels of mRNAs and proteins related to tumor progression. Results: CCL20 was upregulated in GCTSCs and correlated with tumor progression and prognosis. CCL20 induced GCTSC proliferation and migration in an autocrine manner. In addition, CCL20 recruited mononuclear cells and induced osteoclastogenesis by overactivating the AKT and NF-κB signaling pathways. Antibody blockade of CCL20 abolished the exacerbated osteoclastogenesis. Conclusion: Taken together, our data indicate that GCTSC secretion of CCL20 acts as a key modulator in the pathological progression of GCTB. It can promote GCTSC proliferation and migration in an autocrine manner and can recruit bone marrow monocytes to the tumor microenvironment and enhance osteoclastogenesis in a paracrine manner. These findings strongly indicate the potential prognostic and therapeutic value of CCL20 in GCTB.

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“…En block excision is the optimal treatment option which is designed based on modern imaging techniques such as Magnetic Resonance Imaging (MRI) but may be extensive and disabling for the patient 10,27 . Yin et al in their series of 14 patients reported statistically significant lower local recurrence rates of malignant GCTs of the spine with total en bloc spondylectomy compared to subtotal or piecemeal total resections 28 . In the series of Kapoor SK et al, patients that developed malignant GCT and treated with en bloc excision, died within 5 months post diagnosis 29 .…”

mentioning

confidence: 96%