Secondary Malignancy in Giant Cell Tumor: A Single-Center Study

Abstract Giant cell tumor of bone (GCTB) uncommonly undergoes sarcomatous transformation. Secondary malignancy in giant cell tumor (MGCT) develops at the prior treatment site, and is associated with radiotherapy and dismal prognosis. The objective of this study is to investigate the clinicopathological characteristics of MGCT patients. We reviewed medical records of patients with secondary MGCT. Twelve patients were analyzed including six females and six males, with a median age of 42.5 years. Benign recurrence occurred in five GCTB patients, who were not treated with radiotherapy. No pulmonary implants were observed. The median latency was 63 months. Nine patients were AJCC stage IIB, and three were stage IVA. The median follow-up period after malignant transformation was 62.5 months. Five patients developed local recurrence and six had metastasis. Five-year overall, recurrence- and metastasis-free survivals were 61.9%, 66.7% and 58.3%. The local recurrence of GCTB was a potential factor for metastasis-free survival. Difference in overall survival according to benign local recurrence was almost significant. In our series, the occurrence of secondary MGCT did not follow radiotherapy, contrary to the Western literature. The prognosis was better than the findings reported in previous studies. The local recurrence of benign GCTB could reflect the prognosis of MGCT.

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Preoperative CT for prediction of local recurrence after curettage of giant cell tumor of bone

Journal of Bone Oncology ◽

10.1016/j.jbo.2021.100366 ◽

2021 ◽

pp. 100366

Author(s):

Lenian Zhou ◽

Shanyi Lin ◽

Hanqiang Jin ◽

Zhaoyuan Zhang ◽

Changqing Zhang ◽

...

Keyword(s):

Local Recurrence ◽

Giant Cell Tumor ◽

Giant Cell ◽

Cell Tumor ◽

Preoperative Ct

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Giant Cell Tumor of Bone: 413 Patients, Analysis of Recurrence Rate and Local Recurrence Risk Factors

OrthoMedia ◽

10.1302/3114-210205 ◽

2021 ◽

Keyword(s):

Risk Factors ◽

Local Recurrence ◽

Giant Cell Tumor ◽

Giant Cell ◽

Recurrence Rate ◽

Recurrence Risk ◽

Cell Tumor

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Clinical and pathological analysis of giant cell tumor of bone with denosumab treatment and local recurrence

Journal of Orthopaedic Science ◽

10.1016/j.jos.2020.11.005 ◽

2020 ◽

Author(s):

Kenta Hayashida ◽

Yusuke Kawabata ◽

Ikuma Kato ◽

Takayuki Kamiishi ◽

Kosuke Matsuo ◽

...

Keyword(s):

Local Recurrence ◽

Giant Cell Tumor ◽

Giant Cell ◽

Cell Tumor ◽

Pathological Analysis ◽

Denosumab Treatment

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Impact Severity of Local Recurrence in Giant Cell Tumor of Bone

Clinical Orthopaedics and Related Research ◽

10.1097/01.blo.0000180055.76969.08 ◽

2005 ◽

Vol &NA; (438) ◽

pp. 116-122 ◽

Cited By ~ 44

Author(s):

Richard L McGough ◽

Janie Rutledge ◽

Valerae O Lewis ◽

Patrick P Lin ◽

Alan W Yasko

Keyword(s):

Local Recurrence ◽

Giant Cell Tumor ◽

Giant Cell ◽

Cell Tumor

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Local Recurrence of Giant Cell Tumor of Bone After Intralesional Treatment with and without Adjuvant Therapy

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.d.02771 ◽

2008 ◽

Vol 90 (5) ◽

pp. 1060-1067 ◽

Cited By ~ 204

Author(s):

Arbeitsgemeinschaft Knochentumoren

Keyword(s):

Local Recurrence ◽

Adjuvant Therapy ◽

Giant Cell Tumor ◽

Giant Cell ◽

Cell Tumor ◽

Intralesional Treatment

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Multiple Pulmonary Metastases of Giant Cell Tumor of Bone with expression of VEGFR-2 Successfully Treated by Denosumab and Apatinib: A Rare Case Report

10.21203/rs.3.rs-221200/v1 ◽

2021 ◽

Author(s):

taojun gong ◽

Yi Luo ◽

Yitian Wang ◽

Chuanxi Zheng ◽

Jianguo Fang ◽

...

Keyword(s):

Computed Tomography ◽

Case Report ◽

Local Recurrence ◽

Giant Cell Tumor ◽

Giant Cell ◽

Pulmonary Metastases ◽

Cell Tumor ◽

Wide Resection ◽

High Tendency ◽

Bony Destruction

Abstract Background: Giant cell tumor of bone (GCTB) is a rare benign but locally aggressive bone tumor. It has a high tendency for local recurrence, which may increase the occurrence of lung metastasis. Currently, the treatment of pulmonary metastases of GCTB is controversial. Denosumab is the preferred regimen for unresectable metastatic lesions, but there are no alternative treatment options when denosumab is resistant. So far, no case reports of metastatic GCTB treated with denosumab and apatinib have been published. Case presentation: This is a case report of a 26-year-old female who experienced right knee pain for over 6 months. Radiography and computed tomography revealed osteolytic bony destruction in the proximal right tibia. Using histological, radiological, and clinical techniques, a diagnosis of GCTB was achieved. Meanwhile, the immunohistochemical stain-identified the tumor cells were positive for vascular endothelial growth factor receptor 2 (VEGFR-2). After intralesional curettage of the primary tumor and wide resection of local recurrence surgeries, she developed recurrent hemoptysis. Chest computed tomography (CT) images showed multiple pulmonary nodules. She was administrated denosumab therapy but disease progression was confirmed after four months of treatment. She then received denosumab and apatinib therapy for 24 months, after a partial response was achieved.Conclusions: We depict a case of multiple pulmonary metastases of GCTB successfully controlled by denosumab and apatinib therapy. VEGFR-2 may be an effective therapeutic target for GCTB with pulmonary metastasis when denosumab is ineffective.

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Malignancy in Giant Cell Tumor of Bone: A Review of the Literature

Technology in Cancer Research & Treatment ◽

10.1177/1533033819840000 ◽

2019 ◽

Vol 18 ◽

pp. 153303381984000 ◽

Cited By ~ 14

Author(s):

Emanuela Palmerini ◽

Piero Picci ◽

Peter Reichardt ◽

Gerald Downey

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Cumulative Incidence ◽

Cell Tumor ◽

Secondary Malignancy ◽

Primary Malignancy ◽

Optimal Care ◽

True Incidence ◽

Small Series ◽

Malignant Giant Cell Tumor

Background: Primary and recurrent giant cell tumor of bone is typically benign; however, rarely giant cell tumor of bone can undergo malignant transformation. Malignancy in giant cell tumor of bone may be primary (adjacent to benign giant cell tumor of bone at first diagnosis) or secondary (at the site of previously treated giant cell tumor of bone). Malignant giant cell tumor of bone has a poor prognosis; it is important to distinguish malignant from benign lesions to facilitate appropriate management. The true incidence of malignant giant cell tumor of bone is not known, probably owing to inaccurate diagnosis and inconsistent nomenclature. We have analyzed current data to provide a robust estimate of the incidence of malignancy in giant cell tumor of bone. Methods: A literature search was performed to source published reports of primary and secondary cases of malignant giant cell tumor of bone. Studies that reported a denominator were used to estimate the incidence of malignancy. Results: We identified 4 large series of patients with malignant giant cell tumor of bone that provided data on 2315 patients with giant cell tumor of bone. Across these studies, the cumulative incidence of malignancy was 4.0%; the cumulative incidence of primary malignancy was 1.6% compared with 2.4% for secondary malignancy. Our analyses confirmed that most malignant giant cell tumor of bone is secondary and occurs following radiation. In addition, data from 8 small series showed that 4.8% of patients with giant cell tumor of bone who received radiation therapy developed secondary malignancy. Conclusions: Malignant giant cell tumor of bone is rare, and its identification is hindered by a lack of clear diagnostic criteria. For optimal care of patients with giant cell tumor of bone, we recommend: comprehensive histologic sampling to ensure accurate diagnoses; watchful follow-up, particularly for patients treated with radiation; and timely treatment of local recurrence.

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