Spondylectomy for Giant Cell Tumor After Denosumab Therapy.

Abstract:

STUDY DESIGN:A case report. OBJECTIVE:To report a case of the lumbar giant cell tumor (GCT) utilizing a new clinical treatment modality (denosumab therapy), which showed a massive tumor reduction combined with the L4 spondylectomy. SUMMARY OF BACKGROUND DATA:There are some controversies about spinal GCT treatments. Denosumab has provided good clinical results in terms of tumor shrinkage, and local control in a short-time follow-up clinical study phase 2, although for spinal lesions, it has not been described. Nonetheless, "en bloc" spondylectomy has been accepted as being the best treatments modalities in terms of oncological control. METHODS:A case study with follow-up examination and series radiological assessments 6 months after therapy started, followed by a complex spine surgery. RESULTS:The denosumab therapy showed on the lumbar computed tomography scans follow-up 6 months later, a marked tumor regression around 90% associated to vertebral body calcification, facilitating a successful L4 spondylectomy with an anterior and posterior reconstruction. The patient recovered without neurological deficits. CONCLUSION:A new therapeutic modality for spinal GCT is available and showing striking clinical results; however, it is necessary for well-designed studies to answer the real role of denosumab therapy avoiding or facilitating complex spine surgeries as spondylectomies for spinal GCT. LEVEL OF EVIDENCE:5.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

de Carvalho Cavalcante RA,Silva Marques RA,dos Santos VG,Sabino E,Fraga AC Jr,Zaccariotti VA,Arruda JB,Fernandes YB

doi

10.1097/BRS.0000000000001191

subject

Has Abstract

pub_date

2016-02-01 00:00:00

pages

E178-82

issue

3

eissn

0362-2436

issn

1528-1159

journal_volume

41

pub_type

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