Clinical Report: Metachronous Multicentric Giant Cell Tumor of Bone
Overview
This report presents a rare case of metachronous multicentric giant cell tumor of bone (MGCTB) with pulmonary metastases, managed over 20 years. The patient achieved sustained disease stabilization through long-term denosumab therapy, highlighting its critical role in controlling this aggressive variant.
Background
Giant cell tumor of bone (GCTB) is a locally aggressive tumor that primarily affects young adults. While typically solitary, multicentric forms with pulmonary metastases are exceedingly rare and present significant management challenges. Understanding the clinical behavior and treatment options for MGCTB is essential for improving patient outcomes.
Data Highlights
No numerical data or trial data was provided in the source material.
Key Findings
The patient was diagnosed with MGCTB and pulmonary metastases, with a follow-up period of over 20 years.
Multiple surgical interventions were performed, including curettage, resection, and amputation, but the disease progressed.
Denosumab therapy initiated in 2017 led to sustained disease stabilization.
A treatment interruption during the COVID-19 pandemic was followed by a resumption of denosumab in 2021, which effectively controlled systemic lesions.
Despite ongoing treatment, a progressing rib lesion required wide en bloc resection in 2022.
The patient continues on denosumab with well-controlled disease and no evidence of progression.
Clinical Implications
This case emphasizes the importance of continuous systemic therapy, such as denosumab, in managing MGCTB, particularly when surgical options are limited. Clinicians should consider long-term follow-up and monitoring for potential metastases in patients with GCTB.
Conclusion
The successful management of this rare case of MGCTB illustrates the potential of targeted biologic therapy in achieving long-term disease control. Continuous systemic therapy remains a critical component in the treatment of advanced GCTB variants.
