Neoadjuvant denosumab for the treatment of a sacral osteoblastoma View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-07

AUTHORS

Jeremy J. Reynolds, Dominique A. Rothenfluh, Nick Athanasou, Shaun Wilson, David C. Kieser

ABSTRACT

PURPOSE: To present a case of aggressive sacral osteoblastoma (OB) treated with neoadjuvant denosumab therapy and en bloc resection. METHODS: Case report of a 14-year-old male with an aggressive OB affecting the superior articular process of the left first sacral segment. The lesion was lytic and metabolically active and involved the left-sided posterior elements of S1-S3 with extension into the spinal canal, affecting the left S1, S2, S3, S4 and S5 nerve roots. He was treated for 1 month with neoadjuvant denosumab followed by en bloc resection. RESULTS: Denosumab therapy caused regression of the tumour and converted the diffuse infiltrative mass into a well-defined solid (osteoma-like) structure, aiding surgical resection and preserving the S1, S4 and S5 nerve roots. Histologically, the treated lesion showed abundant sclerotic woven bone and osteoblasts with absence of osteoclasts. CONCLUSIONS: A short course of denosumab caused tumour regression, ossification and conversion of an aggressive OB into a sclerotic, well-defined lesion thus aiding surgical resection and preservation of neural structures. Neoadjuvant therapy reduced osteoclast numbers but PET showed that the lesion remained FDG avid post-therapy. More... »

PAGES

446-452

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00586-018-5461-z

DOI

http://dx.doi.org/10.1007/s00586-018-5461-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1100558410

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29356985


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