Osteosclerosis induced by denosumab

Abstract

A 10-year-old boy, 144 cm tall, was referred to our hospital in October, 2012, with a 2 month history of persistent pain in the buttocks. He had altered gait due to pain, but no disturbance of bladder or bowels. Radiographs, CT, and MRI showed a large osteolytic lesion in the sacrum, and examination of a bone biopsy sample confirmed a giant cell tumour of bone, which we considered to be unresectable because of the potential risk of neurological deficit and massive bleeding. We obtained informed consent from the patient and his parents and the review board for off-label use of denosumab, a potent inhibitor of osteoclastic bone resorption, to reduce the tumour mass.