Malignant Transformation of Giant Cell Tumor of Bone and the Association with Denosumab Treatment: A Radiology and Pathology Perspective.
Objective. Malignancy in giant cell tumor of bone (mGCTB) is categorized as primary (concomitantly with conventional GCTB) or secondary (after radiotherapy or other treatment). Denosumab therapy has been suggested to play a role in the etiology of secondary mGCTB. In this case series from a tertiary...
| Published in: | Sarcoma pp. 1 - 12 |
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| Main Authors: | , , , , , , |
| Format: | diagnostic images pictorial research tables/charts Journal Article |
| Published: |
Wiley-Blackwell
7/5/2022
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=157818818&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 157818818 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1357714X 57R jtl: Sarcoma issn: 1357714X maglogo: Y pubinfo: dt: 7/5/2022 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 157818818 157818818 157818818 10.1155/2022/3425221 157818818 ppf: 1 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Malignant Transformation of Giant Cell Tumor of Bone and the Association with Denosumab Treatment: A Radiology and Pathology Perspective. aug: au: van Langevelde, K. Cleven, A. H. G. Navas Cañete, A. van der Heijden, L. van de Sande, M. A. J. Gelderblom, H. Bovée, J. V. M. G. affil: Department of Radiology, Leiden University Medical Center, Leiden, Netherlands sug: subj: Giant Cell Tumor of Bone Pathology Giant Cell Tumor of Bone Drug Therapy Antibodies, Monoclonal Therapeutic Use Antineoplastic Agents Therapeutic Use Human Time Factors Histology Surgery, Operative Radiotherapy, Conformal Diagnostic Imaging ab: Objective. Malignancy in giant cell tumor of bone (mGCTB) is categorized as primary (concomitantly with conventional GCTB) or secondary (after radiotherapy or other treatment). Denosumab therapy has been suggested to play a role in the etiology of secondary mGCTB. In this case series from a tertiary referral sarcoma center, we aimed to find distinctive features for malignant transformation in GCTB on different imaging modalities. Furthermore, we assessed the duration of denosumab treatment and lag time to the development of malignancy. Methods. From a histopathology database search, 6 patients were pathologically confirmed as having initial conventional GCTB and subsequently with secondary mGCTB. Results. At the time of mGCTB diagnosis, 2 cases were treated with denosumab only, 2 with denosumab and surgery, 1 with multiple curettages and radiotherapy, and 1 with surgery only. In the 4 denosumab treated patients, the mean lag time to malignant transformation was 7 months (range 2–11 months). Imaging findings suspicious of malignant transformation related to denosumab therapy are the absence of fibro-osseous matrix formation and absent neocortex formation on CT, and stable or even increased size of the soft tissue component. Conclusion. In 4 patients treated with denosumab, secondary mGCTB occurred within the first year after initiation of treatment. Radiotherapy-associated mGCTB has a longer lag time than denosumab-associated mGCTB. Close clinical and imaging follow-up during the first months of denosumab therapy is key, as mGCTB tends to have rapid aggressive behavior, similar to other high-grade sarcomas. Nonresponders should be (re) evaluated for their primary diagnosis of conventional GCTB. pubtype: Academic Journal doctype: diagnostic images pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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