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Review
. 2019 Nov-Dec;10(6):1027-1032.
doi: 10.1016/j.jcot.2019.09.025. Epub 2019 Oct 9.

Axial giant cell tumor - current standard of practice

Navaneeth Kamath  1 , Jasmine Agarwal  1 , Ashish Gulia  1
Affiliations
Review

Axial giant cell tumor - current standard of practice

Navaneeth Kamath et al. J Clin Orthop Trauma. 2019 Nov-Dec.

Erratum in

  • Erratum regarding previously published articles.
    [No authors listed] [No authors listed] J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1169-1171. doi: 10.1016/j.jcot.2020.09.032. Epub 2020 Sep 26. J Clin Orthop Trauma. 2020. PMID: 33013141 Free PMC article.
  • Erratum regarding previously published articles.
    [No authors listed] [No authors listed] J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1172-1174. doi: 10.1016/j.jcot.2020.10.044. Epub 2020 Oct 23. J Clin Orthop Trauma. 2020. PMID: 33192025 Free PMC article.
  • Erratum regarding previously published articles.
    [No authors listed] [No authors listed] J Clin Orthop Trauma. 2021 Aug 5;21:101556. doi: 10.1016/j.jcot.2021.101556. eCollection 2021 Oct. J Clin Orthop Trauma. 2021. PMID: 34414070 Free PMC article.

Abstract

Giant cell tumors of bone are relatively rare in the axial skeleton, accounting for approximately 6.7% of all cases. Due to their anatomical complexity, difficult access and proximity to vital neurovascular structures, management of these tumors poses a huge challenge on the treating surgeon. Several data series reported on axial GCTB involve short series of limited cases with varied methods used in their local control due to which, proper guidelines are unavailable for the management of such difficult cases. Though the present data support the use of denosumab for effective management of these lesions but there is varied consensus on dosage and duration of treatment. This review article summarizes the basic features and treatment modalities related to axial GCTB stressing on multidisciplinary approach to achieve optimum outcomes.

Keywords: Angioembolization; Axial; Curettage; Denosumab; Giant cell tumor; Management.

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Figures

Fig. 1
Fig. 1
shows the imaging of a 38-year old male diagnosed with L3 Vertebral GCTB (A,B – Plain Radiograph of Lumbosacral spine Anteroposterior and Lateral views showing lytic lesion in L3 vertebral body; C,D,E − MRI Spine axial, coronal and sagittal views with GCTB of L3 and large soft tissue component compressing the cord) treated with 2 cycles of angioembolization followed by Decompression Laminectomy of L3 vertebra + radial screw + cage fixation (F) followed by another angioembolization to control the recurrence (G) and a static and well ossified lesion on 4-year follow up imaging (H – Plain Radiograph Lateral view).
Fig. 2
Fig. 2
shows images of a 32-year male with a large sacral GCT (A – Plain Radiograph Pelvis Anteroposterior view; B,C – MRI Pelvis Sagittal and Axial views showing the sacral bony lesion with a large soft tissue component), treated with Denosumab and Angioembolization (D) with response and controlled disease after 5 years of follow up (E,F – MRI Pelvis Sagittal and Axial views showing significant reduction in soft tissue component).
Fig. 3
Fig. 3
shows images of a 32-year female with D1-2 Vertebral GCT (A,B – Plain Radiograph Cervicodorsal spine Lateral and Anteroposterior views; C,D – MRI Spine Coronal and Sagittal views showing D1-2 vertebral lesion with intrathoracic extension) managed with Denosumab and definitive RT (50.4Gy/28#), given in view of poor response to the former with evident response (E,F – Plain Radiograph Lateral and Anteroposterior views; G,H – MRI Spine Axial and Sagittal views post Denosumab and RT).
Fig. 4
Fig. 4
Algorithm – management of axial GCTB.
See this image and copyright information in PMC

References

    1. Balke M., Henrichs M.P., Gosheger G. Giant cell tumors of the axial skeleton. Sarcoma. 2012;2012:410973. - PMC - PubMed
    1. Thangaraj R., Grimer R.J., Carter S.R., Stirling A.J., Spilsbury J., Spooner D. Giant cell tumour of the sacrum: a suggested algorithm for treatment. Eur Spine J. 2010;19(7):1189–1194. - PMC - PubMed
    1. van der Heijden L., van de Sande M.A.J., van der Geest I.C.M. Giant cell tumors of the sacrum--a nationwide study on midterm results in 26 patients after intralesional excision. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2014;23(9):1949–1962. - PubMed
    1. Ma Y., Xu W., Yin H. Therapeutic radiotherapy for giant cell tumor of the spine: a systemic review. Eur spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2015;24(8):1754–1760. - PubMed
    1. Carrasco C.H., Murray J.A. vol 20. 1989. Giant cell tumors; pp. 395–405. (Orthopedic Clinics of North America). - PubMed