Denosumab in irresectable giant cell tumour of the cervical spine

Abstract

Giant cell tumours of bone (GCTB) are rare benign, locally aggressive bone tumours that are characterised by mononucleated mesenchymal stromal cells that overexpress receptor activator nuclear factor kappa B (RANK) ligand and multinucleated osteoclast-like giant cells that express RANK. Surgery is the primary management option for operable disease but may cause significant functional morbidity in cervical vertebral GCTB. Case series of denosumab use in irresectable GCTB have reported good long term local control and downgrading of surgical extent. Concerns exist about the increased risk of local recurrence when neoadjuvant denosumab is followed by intralesional surgery, and when treatment is discontinued in cases of advanced disease. Contribution: We describe the management of a 21-year-old female with cervical vertebral GCTB with long-term adjuvant denosumab after partial resection who continues to show good clinical and radiologic control.

Keywords

• giant cell tumour
• cervical spine
• irresectable
• radiotherapy
• denosumab.