■骨巨细胞瘤(GCTB)是一种罕见但局部侵袭性肿瘤,主要影响年轻人。其标志特征包括多核破骨细胞型巨细胞和单核细胞肿瘤细胞。用denosumab治疗,抗RANK配体抗体,已经显示出功效,但它改变了组织形态学,提出诊断挑战。伴有软骨发育不全,虽然罕见,在骨病变评估中值得考虑。
■一名30岁男性软骨发育不全,表现为股骨近端GCT,一个罕见的协会。由于肿瘤皮质和皮质臀位薄,给予新佐剂denosumab。进行骨水泥填充和Philo板补充的手术切除。治疗后的组织病理学检查显示不存在破骨细胞型巨细胞,广泛的坏死,透明质化,和单核渗透。
■Denosumab诱导破骨细胞数量减少,导致肿瘤缩小和硬化,同时改变典型的GCT组织学。文献中也有类似的发现,包括像纺锤形细胞这样的基质变化,炎症,血管增生,和含铁血黄素的泡沫巨噬细胞.识别这些改变对于准确诊断至关重要。
■GCT,虽然罕见,具有独特的组织病理学特征,有助于诊断。Denosumab治疗改变了肿瘤形态,需要进行全面的临床评估以进行治疗后的准确诊断。理解,这些挑战对于GCT病例的优化管理至关重要.
UNASSIGNED: Giant cell tumor of bone (GCTB) is a rare yet locally aggressive neoplasm primarily affecting young adults. Its hallmark features include multinucleated osteoclast-type giant cells and mononuclear tumor cells. Treatment with denosumab, an anti-RANK ligand antibody, has shown efficacy, but it alters histomorphology, posing diagnostic challenges. Co-occurrence with
achondroplasia, though rare, warrants consideration in bone lesion evaluations.
UNASSIGNED: A 30-year-old male with
achondroplasia presented with a proximal femur GCT, a rare association. Neoadjuvant denosumab was administered due to thin tumor cortex and cortical breech. Surgical excision with bone cement filling and Philo\'s plate supplementation was performed. Histopathological examination post-treatment revealed the absence of osteoclast-type giant cells, extensive necrosis, hyalinization, and mononuclear infiltrates.
UNASSIGNED: Denosumab induces a reduction in osteoclast numbers, causing tumor shrinkage and sclerosis, while altering typical GCT histology. Similar findings were noted in the literature, including stromal changes like spindle-shaped cells, inflammation, vascular proliferation, and hemosiderin-laden foamy macrophages. Recognition of these alterations is crucial for accurate diagnosis.
UNASSIGNED: GCT, though rare, presents distinct histopathological features aiding diagnosis. Denosumab treatment modifies tumor morphology, necessitating thorough clinical evaluation for accurate diagnosis post-treatment. Understanding, these challenges is essential for optimal management of GCT cases.