Giant Cell Tumor of Bone With Pseudosarcomatous Changes Leading to Premature Denosumab Therapy Interruption: A Case Report With Review of the Literature

Denosumab has shown promising results in the management of giant cell tumor of bone, a primary bone tumor with locally aggressive behaviour. We report a case of premature denosumab interruption due to radiological and clinical tumor expansion of a giant cell tumor of the distal ulna. Although denosu...

Full description

Saved in:
Bibliographic Details
Published inInternational journal of surgical pathology Vol. 24; no. 4; p. 366
Main Authors Sanchez-Pareja, Andrea, Larousserie, Frédérique, Boudabbous, Sana, Beaulieu, Jean-Yves, Mach, Nicolas, Saiji, Essia, Rougemont, Anne-Laure
Format Journal Article
LanguageEnglish
Published United States 01.06.2016
Subjects
Adult
Antineoplastic Agents - administration & dosage
Bone Neoplasms - drug therapy
Bone Neoplasms - genetics
Bone Neoplasms - pathology
Denosumab - administration & dosage
Diagnosis, Differential
Giant Cell Tumor of Bone - drug therapy
Giant Cell Tumor of Bone - genetics
Giant Cell Tumor of Bone - pathology
Histones - metabolism
Humans
Male
Osteosarcoma - diagnosis
Osteosarcoma - pathology
Polymerase Chain Reaction
Ulna - drug effects
Ulna - pathology
RANKL
denosumab therapy
giant cell tumor of bone
sarcoma
Online AccessGet more information

Cover

More Information
Summary:Denosumab has shown promising results in the management of giant cell tumor of bone, a primary bone tumor with locally aggressive behaviour. We report a case of premature denosumab interruption due to radiological and clinical tumor expansion of a giant cell tumor of the distal ulna. Although denosumab is known to induce tumor regression, with progressive ossification and loss of the characteristic morphology of giant cell tumor of bone, the ulnar tumor specimen showed a moderately to highly cellular proliferation of short spindle-shaped cells, and no osteoclast-like giant cells. There were no abnormal mitotic figures. We considered the surgical specimen as a giant cell tumor of bone with partial regression after prematurely interrupted denosumab treatment. This case illustrates the diagnostic issues of an initially unfavourable evolution raising concern for malignancy, and the difficulties in histological assessment of a partially treated giant cell tumor of bone, that may mimic osteosarcoma.
ISSN:1940-2465
DOI:10.1177/1066896916629546