Successful total en bloc spondylectomy of the L3 vertebra with a paravertebral giant cell tumor following preoperative treatment with denosumab: a case report.
Bone Density Conservation Agents
/ therapeutic use
Denosumab
/ therapeutic use
Female
Giant Cell Tumor of Bone
/ diagnostic imaging
Humans
Low Back Pain
/ etiology
Lumbar Vertebrae
/ diagnostic imaging
Orthopedic Procedures
/ methods
Preoperative Care
/ methods
Radiography
Spinal Neoplasms
/ diagnostic imaging
Treatment Outcome
Young Adult
Denosumab
Giant cell tumor
Paravertebral lesion
Total en bloc spondylectomy
Journal
Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382
Informations de publication
Date de publication:
26 Apr 2019
26 Apr 2019
Historique:
received:
10
08
2018
accepted:
24
02
2019
entrez:
27
4
2019
pubmed:
27
4
2019
medline:
26
11
2019
Statut:
epublish
Résumé
Giant cell tumor is known to be a benign neoplasm that arises most commonly in the long bones, while cases in the spine are rare. Recently, denosumab, a monoclonal antibody that inhibits receptor activator of nuclear factor-kappa β ligand, has been used to treat patients with giant cell tumor. However, there are few reports of total en bloc spondylectomy being used for paravertebral giant cell tumor lesions following denosumab therapy. Our patient was a 20-year-old Japanese woman with a 4-month history of lower back pain. A spinal computed tomography scan and magnetic resonance imaging of her lumbar spine revealed an osteolytic lesion involving the L3 vertebral body, and the tumor extended toward the left side of the paravertebral soft tissue and into the left pedicle. The lesion was diagnosed as a giant cell tumor by needle biopsy. Denosumab treatment calcified the paravertebral giant cell tumor lesion and the tumor vertebral body was removed completely by total en bloc spondylectomy. This case report describes a patient with a paravertebral giant cell tumor who was successfully treated by preoperative denosumab injection followed by total en bloc spondylectomy.
Sections du résumé
BACKGROUND
BACKGROUND
Giant cell tumor is known to be a benign neoplasm that arises most commonly in the long bones, while cases in the spine are rare. Recently, denosumab, a monoclonal antibody that inhibits receptor activator of nuclear factor-kappa β ligand, has been used to treat patients with giant cell tumor. However, there are few reports of total en bloc spondylectomy being used for paravertebral giant cell tumor lesions following denosumab therapy.
CASE PRESENTATION
METHODS
Our patient was a 20-year-old Japanese woman with a 4-month history of lower back pain. A spinal computed tomography scan and magnetic resonance imaging of her lumbar spine revealed an osteolytic lesion involving the L3 vertebral body, and the tumor extended toward the left side of the paravertebral soft tissue and into the left pedicle. The lesion was diagnosed as a giant cell tumor by needle biopsy. Denosumab treatment calcified the paravertebral giant cell tumor lesion and the tumor vertebral body was removed completely by total en bloc spondylectomy.
CONCLUSION
CONCLUSIONS
This case report describes a patient with a paravertebral giant cell tumor who was successfully treated by preoperative denosumab injection followed by total en bloc spondylectomy.
Identifiants
pubmed: 31023361
doi: 10.1186/s13256-019-2029-4
pii: 10.1186/s13256-019-2029-4
pmc: PMC6485048
doi:
Substances chimiques
Bone Density Conservation Agents
0
Denosumab
4EQZ6YO2HI
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
116Références
Histol Histopathol. 2001 Jan;16(1):297-307
pubmed: 11193206
N Engl J Med. 2006 Feb 23;354(8):821-31
pubmed: 16495394
Spine (Phila Pa 1976). 2009 Oct 15;34(22 Suppl):S39-47
pubmed: 19829276
Lancet Oncol. 2010 Mar;11(3):275-80
pubmed: 20149736
Spine (Phila Pa 1976). 2011 May 1;36(10):830-6
pubmed: 20714276
Spine (Phila Pa 1976). 2011 Jan 1;36(1):74-82
pubmed: 20823784
Lancet Oncol. 2013 Aug;14(9):901-8
pubmed: 23867211
Evid Based Spine Care J. 2014 Oct;5(2):151-7
pubmed: 25364329
J Neurosurg Spine. 2015 May;22(5):526-33
pubmed: 25700239
Case Rep Med. 2015;2015:767198
pubmed: 26798348
Asian Spine J. 2016 Jun;10(3):553-7
pubmed: 27340537
Eur J Cancer. 2017 May;77:75-83
pubmed: 28365529
Chin Med J (Engl). 2017 Jul 5;130(13):1557-1563
pubmed: 28639571
Int Orthop. 2017 Nov;41(11):2397-2400
pubmed: 28646421
Oncol Lett. 2017 Oct;14(4):4005-4010
pubmed: 28943907
Am J Med Sci. 2018 May;355(5):506-509
pubmed: 29753381
Cancer. 1977 Mar;39(3):1350-6
pubmed: 912665
Spine (Phila Pa 1976). 1997 May 1;22(9):1036-44
pubmed: 9152458