Effect of denosumab in giant cell tumor of bone

Abstract

Giant cell tumor (GCT) of bone is a benign tumor with locally aggressive nature. The presence of mononuclear stromal cells and multinucleated giant cells is the microscopic characteristic feature of the GCT. It is an osteoclastic tumor with destruction of tumor is mediated by the receptor activator of nuclear factor kappa-B ligand (RANKL). Denosumab, a RANKL inhibitor, may reduce or eliminate tumor giant cells, the relative content of proliferative, densely cellular tumor stromal cells, replacing with nonproliferative, differentiated woven new bone. We report a case of GCT of the right distal femur in a 20-year-old female, treated with 6 cycles of denosumab as neoadjuvant therapy, which shows consolidation of the lesion and became amenable for extended curettage with phenol cauterization and cementing without going for any radical surgery shown to have very good functional outcome.