Metastatic giant cell tumour of bone: a narrative review of management options and approaches

Abstract

Giant cell tumour of bone (GCTB) is a locally aggressive bone neoplasm with a rare tendency to metastasise, most commonly to the lungs. The management of metastatic GCTB (metGCTB) is controversial due to its unpredictable behaviour. Asymptomatic patients should be monitored radiologically and undergo treatment only when disease progression occurs. Surgery is recommended for resectable metGCTB. Denosumab, a monoclonal antibody which inhibits receptor activator of nuclear factor‐κB ligand, is recommended for unresectable metGCTB with evidence from phase II trials demonstrating its safety and efficacy. Relapse after denosumab withdrawal may occur and prolonged treatment may be associated with serious adverse events, thus further research is warranted to inform a maintenance regimen with reduced dosing and frequency. Combined denosumab and bisphosphonate therapy has the potential to achieve sustained disease control or remission in unresectable metGCTB without requiring long‐term treatment and should be evaluated in prospective trials. Various novel agents have demonstrated in vitro and anecdotal efficacy and warrant further evaluation.

Uncommon Presentation of a Giant Cell Tumor of the Skull in a Pediatric Patient: A Case Report

“…Even though bone GCTs are considered benign lesions, they can be locally aggressive invading the surrounding tissue1. Further, a malignant variant has also been reported, with metastasis to the lungs [9].…”

Giant Cell Tumor: Pathogenesis and Clinical Manifestation

“…Penyebab pasti dari proliferasi SC dan overekspresi ligan RANK (RANKL) tidak diketahui. Namun, mutasi pada gen H3F3A (mengkodekan varian histone H3F3A-G34W) yang ditemukan hampir secara eksklusif di SC baru-baru ini ditemukan cukup untuk mendorong tumorigenesis di GCTB (Xu & Choong, 2022). Patogenesis molekuler dan biologi GCTB terdiri dari 4 proses, yaitu tumorigenesis sel stroma mononuklear neoplastik, generasi giant cell berinti banyak yang reaktif, resorpsi/migrasi tulang, serta remodeling matriks tulang untuk angiogenesis, invasi, dan metastasis (Noh & Park, 2018).…”

Management of a rare giant cell tumor of the distal fibula: A case report

“…When GCTB is close to the joint, it poses challenges in the surgical management. Lesion resection, prosthesis replacement, or bone graft reconstruction are often used for salvage treatment, but the joint function can still decrease[ 1 , 10 , 11 ].…”