Giant Cell Tumor Of The Bone Research Articles

Histopathological response to denosumab in giant cell tumours of bone - A review of 11 cases.

Giant cell tumor (GCT) of the bone is a locally aggressive primary bone tumor, that can rarely metastasize. Arising mostly in epiphysis of the long bones in young adults, the tumor is composed of mononuclear cells that are admixed with osteoclastic giant cells(OLGCs), which express RANK ligand and RANK respectively. Denosumab a monoclonal antibody against RANK ligand has been shown to reduce the tumor by causing bone lysis by inhibiting RANKL. Histological changes in 11 patients of GCT who were treated with denosumab are presented here. Clinical records and slides of 11 patients of GCT who had been administered neoadjuvant denosumab were included in the study. Evaluation of pre and post therapy GCT specimens was performed by two pathologists (RK and VM). There were 4 males and 7 females. Their mean age was 30 years. All the patients received 120 mg denosumab subcutaneously every week with additional 120 mg on days 8 and 15 of therapy. The histological slides were reviewed and following points noted: 1) degree of ossification,2) fibrosis,3) loss of osteoclastic giant cells,4) proliferation of mononuclear cells,5) atypia,6) Permeation of osteoid by malignant cells. Out of 11 cases, 2 cases did not show any significant histological improvement. 7 cases showed reduction in giant cells, increased fibrosis, enhanced mononuclear cell proliferation and ossification consistent with a pathological response. Atypia and osteoid permeation were noted in 2 cases which showed transformation to osteosarcoma. Denosumab treated giant cell tumor show dramatic histological changes. The post therapy lesions may bear no resemblance to pretherapy lesion. There may be complete resolution or may be confused with benign or malignant lesions Rarely they may show sarcomatous transformation. It is imperative that the pathologist is aware of these changes to prevent diagnostic pitfalls as it poses therapeutic and prognostic implications.

‘Triple clear’: a systematic and comprehensive surgical process for Campanacci grades II and III giant cell tumors of the bone, with or without pathological fracture and slight joint invasion

BackgroundIn recent years, researchers have proposed a number of adjuvant methods for extended curettage of giant cell tumors of the bone. However, various schemes have significant differences in efficacy and safety. Therefore, this article will describe an empirical expanded curettage protocol, ‘triple clear’, in detail to show the effect of the efficient surgical protocol.MethodPatients with Campanacci grades II and III primary GCTB who were treated with either SR (n = 39) or TC (n = 41) were included. Various perioperative clinical indicators, including the therapy modality, operation time, Campanacci grade, and filling material were recorded and compared. The pain level was determined by the visual analog scale. Limb function was determined by the Musculoskeletal Tumour Society (MSTS) score. Follow-up time, recurrence rates, reoperation rates, and complication rates were also recorded and compared.ResultThe operation time was 135.7 ± 38.4 min in the TC group and 174.2 ± 43.0 min in the SR group (P < 0.05). The recurrence rates were 7.3% in the TC group and 8.3% in the SR group (P = 0.37). The MSTS scores at three months after surgery were 19.8 ± 1.5 in the TC group and 18.8 ± 1.3 in the SR group. The MSTS scores at two years were 26.2 ± 1.2 in the TC group and 24.3 ± 1.4 in the SR group (P < 0.05).ConclusionTC is recommended for patients with Campanacci grade II–III GCTB and for those with a pathological fracture or slight joint invasion. Bone grafts may be more suitable than bone cement in the long term.

Oncogenic zinc finger protein ZNF687 accelerates lung adenocarcinoma cell proliferation and tumor progression by activating the PI3K/AKT signaling pathway

Zinc finger protein 687 (ZNF687) has previously been discovered as a potential oncogene in individuals with giant cell tumors of the bone, acute myeloid leukemia, and hepatocellular carcinoma. However, its role and mechanism in lung adenocarcinoma (LUAD) remain unclear. In LUAD cells, tumor, and matched adjacent tissue specimens, quantitative real-time RT- polymerase chain reaction (qRT-PCR), western blotting analyses, and immunohistochemistry staining (IHC) were conducted. Cell counting kit-8 (CCK8) assay, clonogenicity analysis, flow cytometry, and transwell assays were utilized to detect ZNF687 overexpression and knockdown impacts on cell growth, colony formation, cell cycle, migration, and invasion. Bioinformatic studies, qRT-PCR and western blotting studies were employed to validate the underlying mechanisms and signaling pathways implicated in the oncogenic effect of ZNF687. This study demonstrated that ZNF687 expression was elevated in LUAD cells and tissues. Individuals with upregulated ZNF687 had a poorer prognosis than those with downregulatedZNF687 (p < 0.001). ZNF687 overexpression enhanced LUAD growth, migration, invasion and colony formation, and the cell cycle G1-S transition; additionally, it promoted the epithelial-mesenchymal transition (EMT). In contrast, knocking down ZNF687 showed to have the opposite impact. Moreover, these effects were associated with the activity of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling mechanism. ZNF687 was upregulated in LUAD, and high ZNF687 expression levels are associated with poor prognoses. The activation of the PI3K/AKT signaling pathway by upregulated ZNF687 increased the proliferation of LUAD cells and tumor progression. ZNF687 may be a beneficial predictive marker and a therapeutic target in LUAD.

The Efficacy of Bisphosphonate in the Treatment of Giant Cell Tumour of the Bone: A Systematic Review and Meta-Analysis.

Anti-osteoclastic mechanism of Bisphosphonate (BP) is crucial to treat Giant Cell Tumour of the Bone (GCTB), however no established guidelines of its use have been published. This systematic review and meta-analysis is the first to summarise recent clinical studies on the subject. A systematic search was performed based on PRISMA guidelines for clinical trials of BP administration in GCTB. Baseline data including BP regimen, dose and timing was summarised. The primary outcomes assessed were recurrence rate, metastases, survival rate, functional outcome, clinical outcome, radiological outcome, and adverse effect. We identified 8 articles from 2008-2020. Most studies administer 4mg of Zoledronic acid post-operatively, with five studies mentioning pre-operative administration and six studies describing post-operative administration. There was a total of 181 GCTB cases analysed in this study. The BP group presented lower recurrence rate than control group (three studies; Odds Ratio [OR] 0.15; 95% Confidence Interval [CI], 0.05 - 0.43; p<0.05; heterogeneity, I2=0%). As for survival rate, BP group is comparable to control group (two studies; OR 1.67; 95% CI, 0.06 - 48.46; p=0.77; heterogeneity, I2=65%). Bisphosphonate therapy offers satisfactory recurrence rate, functional outcome, clinical outcome, radiological outcome, survival rate and metastases rate in patients with GCTB, with minimal adverse effects. Pre- and post-operative administration of bisphosphonates in combination might be the most beneficial in minimalising the recurrence rate.

Association between preoperative denosumab and the risk of local recurrence in patients with giant cell tumor of bone: A meta-analysis and systematic review.

This meta-analysis aimed at determining the association between preoperative denosumab and the risk of local recurrence in patients with giant cell tumors of the bone. Web of Science, EMBASE, Cochrane Library, and PubMed were comprehensively searched on April 20th, 2022. Data from the included articles were analyzed using meta-analysis. The bias of all included studies was evaluated according to ROBINS-I. Also, subgroup and sensitivity analyses were performed. Eight studies with 1270 cases (195 in the denosumab group and 1075 in the control group) were eventually included. Patients receiving denosumab before curettage had a higher risk of local recurrence than those who underwent curettage alone (odds ratio: 2.29, 95% confidence intervals: 1.44-3.64, P = 0.0005). The denosumab group showed a significantly higher risk of local recurrence in most subgroup analyses, except for those with preoperative denosumab duration ≤six months/doses (P = 0.66) and sample size ranging from 100 to 180 (P = 0.69). Denosumab before curettage may increase the risk of local recurrence in patients with giant cell tumor of the bone. Preoperative denosumab should be used with caution after weighing an increased risk of local recurrence against the clinical benefits and a duration time of less than six months before surgery is recommended.

AN ODD GIANT CELL TUMOR OF THE ILIAC BONE

Giant cell tumors of the bone are benign primary tumors, that can be locally aggressive causing recurrence and metastasis.They are most commonly located in long bones, and uncommonly in the pelvic bones.We report the case of a young female patient admitted for a mass in her left hip, to which imaging showed an iliac bone tumor and biopsy confirmed the diagnosis of a giant cell tumor of the iliac bone.

CT-Guided RFA for Management of Surgical Relapses of Giant Cell Tumour of Bone.

This retrospective study describes a pilot experience in CT-guided RadioFrequency Ablation (RFA) treatment of 5 Giant Cell Tumour of the bone (GCT) recurrences after surgery. After biopsy to confirm the diagnosis of GCT recurrences, all patients were treated with RFA in a single session. A close follow-up was scheduled with contrast-enhanced MRI starting 1months after treatment. Five lesions were treated in 5 patients. The length of the observation period was between 4 and 100months. One lesion relapsed 4months after the RFA treatment, and the patient underwent a second surgical treatment which included the en-block resection and prosthetic implant. No complications were recorded. The management of GCT relapses with RFA could be an interesting and innovative field. However, the results of this limited series need to be confirmed by further investigations of larger patient cohorts.

Images of giant cell tumor and chondroblastoma around the knee: retrospective analysis of 99 cases.

It is difficult to differentiate giant cell tumors of the bone (GCTB) from chondroblastoma around the knee based on imaging findings. This study analyzed the imaging features of these 2 diseases for better differentiation. This retrospective cross-sectional cohort study reviewed data of patients with pathologically confirmed GCTB (n=81; age 15-75 years; median age 33 years) and chondroblastoma (n=18; age 12-34 years; median age 14 years). In all, 18 imaging signs were analyzed. Patients with chondroblastoma were relatively younger than those with GCTB. On imaging, lesion length was significantly (P<0.00001) smaller in chondroblastoma [range, 15.80-78.30 mm; mean ± standard deviation (SD) 34.15±18.24 mm; 95% confidence interval (CI): 24.05-44.25 mm] than in GCTB [range, 30.10-117.50 mm; mean ± SD 59.73±15.28 mm; 95% CI: 56.24-63.22 mm]. Significantly more (P<0.05) chondroblastoma lesions had calcification (76.5% vs. 1.3%), lobulation (77.8% vs. 32.1%), and swelling range >15 mm (84.6% vs. 41.1%) than did GCTB lesions, whereas significantly more (P<0.05) GCTB lesions were greater than half the host bone diameter (74.1% vs. 16.7%) and had a lesion long axis that was consistent with that of the host bone (98.8% vs. 27.8%). There were no significant differences (P>0.05) between the 2 tumors in the remaining 11 imaging signs. A narrow zone of transition, intratumor calcification, lobulation, tumor transverse diameter greater than the bone diameter, maximum lesion length, consistency between the tumor and bone long axes, and edema range around the lesion >15 mm are parameters that can be used to differentiate GCTB from chondroblastoma around the knee.

Management of giant cell tumor of bone in the era of denosumab: A case series and review of the literature

Giant cell tumor (GCT) of the bone also known as osteoclastoma typically arises from the meta-epiphyseal region of the long bone and comprises 5% of all bone tumors and 20% of benign bone tumors. Understanding pathogenesis is the key to successful systemic therapy with denosumab, a RANK-ligand inhibitor. In this context, we report seven GCT bone-treated denosumab and radiotherapy cases with a diverse clinical presentation from our institute, NRS Medical College, and Hospital Kolkata.

The role of neutrophil to lymphocyte ratio in predicting lung metastasis in giant cell tumor of the extremities.

Inflammation has a vital role in tumor development and metastasis. Changes in blood count parameters have been associated with tumor prognosis. We aimed to evaluate the prognostic significance of neutrophil to lymphocyte ratio (NLR) in predicting lung metastasis of giant cell tumors of the bone (GCTB) of the extremities. 34 GCTB patients (22 males and 12 females) were included in the study. Patients were divided into two groups. The metastasis group (n = 7) included GCTB patients with lung metastasis, while the non-metastasis group (n = 27) included those without lung metastasis. Descriptive statistics and frequency distribution were calculated [age, white blood cell (WBC), neutrophil, lymphocyte, platelets, neutrophil to lymphocyte ratio (NLR), and platelets to lymphocytes ratio (PLR)]. Continuous normal variables were expressed as mean ± standard deviation and compared using Student's t-tests. The receiver operating characteristic (ROC) curve analysis was used to evaluate the ability of NLR and PLR to predict lung metastasis. The factors were considered to be statistically significant at p < 0.05. There were no significant differences between the lymphocyte count (1.81 vs. 2.23 103/mm3), platelet count (436 vs. 364 103/mm3), and PLR values (247 vs. 190) of the two groups (p > 0.05). The WBC count (11.8 vs. 8.95 103/mm3), neutrophil count (8.78 vs. 5.69 103/mm3), and NLR levels (5.45 vs. 2.81) (p < 0.05) were significantly higher in the metastasis group. The presence of an NLR cut-off value of 3.7 significantly predicted the existence of lung metastasis (AUC = 0.857 [95%CI = 0.714-1], p = 0.004) with a sensitivity of 85% and specificity of 82%. NLR may serve as a promising prognostic marker for predicting lung metastasis in GCTB patients.

Assessment of denosumab treatment efficiency in patients with giant cell tumor of bone using CT and MRI (own results and literature review)

Relevance. Giant cell tumor of the bone is most common in people of working age, which determines the high social significance of successful treatment of this category of patients. The main method of treatment is surgical. Currently, the targeted drug denosumab has appeared, the criteria for evaluating the effectiveness of therapy for which, according to the data of radiation methods, are not clearly defined.Target. To analyze and compare the possibilities of CT and MRI in evaluating the effectiveness of denosumab therapy for giant cell tumors.Materials and methods. The data of CT and MRI of 19 patients with giant cell tumor of tubular bones on the background of denosumab therapy were analyzed.Results. Before treatment, the extraosseous component was determined in 57.9 % (n = 11), after – 31.6 % (n = 6). The decrease occurred in 100 %, the disappearance – in 45 % (n = 11) of cases. The thickness of the extraosseous component before treatment ranged from 4 to 43 mm (Me = 15 mm), after treatment it ranged from 0 to 30 mm (Me = 8 mm). The decrease occurred in the range from 4 to 14 mm (M ± SD = 7 ± 4 mm). In 100 % of cases, a sclerotic rim appeared, the thickness of which after treatment ranged from 1 to 5 mm (Me = 3 mm). In the structure of the tumor, fibrosis occurred in 95 % (n = 18), a decrease in the cystic component occurred in 82 % (n = 9) of cases. Perifocal changes decreased in 100 % of cases. In 100 %, the average tumor density increased. The mean tumor density before treatment ranged from 27 to 65 HU (M ± SD = 42 ± 11 HU), after treatment it ranged from 69 to 500 HU (Me = 150 HU). The increase in density occurred in the range from 41 to 454 HU (Me = 101 HU). All differences are statistically significant (p &lt; 0.05).Conclusions. Evaluation of effectiveness with the definition of quantitative and qualitative indicators is possible according to the data of both CT and MRI; with CT, changes are recorded longer, and more indicators available for quantitative measurement are determined.

399P Role of denosumab as targeted therapy in treatment of unresectable or recurrent cases of giant cell tumor of the bone

The primary modality of treatment of Giant cell tumor of bone (GCTB) is surgical resection; which is not always possible given the location and extent of the neoplasm. A recent phase II data have demonstrated denosumab's (RANKL inhibitor) activity concerning disease and symptom control, without significant adverse effects.

LBMON173 Non-functioning Seller Masses: Tumor Types, Surgical Management And Course Over Time

Abstract Introduction Pituitary adenomas (PA) are common. However, not all sellar tumors are PA. The specific diagnosis of a sellar mass can be difficult. Although there is abundant literature on PA, other types of sellar masses are not well described. In particular, their course over time and response to therapy are not well known. In this study, our objectives were to review non-functioning sellar masses treated with trans sphenoidal surgery (TSS) over the last 15 years to understand their types, success of surgery, and course over time. Patients and Methods We retrospectively reviewed all cases of non-functioning sellar masses managed at our hospital over the last 15 years (January 2007-December 2021). Out of 181 sellar masses that were resected by TSS during this period, 91 were functional PA and 90 were non-functional sellar masses. These sellar masses included non-functioning pituitary adenomas and other non-pituitary seller masses operated at our center during the above period and are the subject of this study. Results The patients included 29 (32%) females and 61 (68%) males with a median age of 41 years (range 13-75 years). The sellar masses were non-functional PA in 50 (55.6%)cases, atypical PA in 30 (33.3%) cases and non-PA in 10 (11%) cases. The 10 non-PA tumors included craniopharyngioma 3 cases, meningioma 3 cases, chordoma 1 case, giant cell tumor of the bone 1 case, spindle cell oncocytoma 1 case and Rathke cyst 1 case. The median largest tumor diameter was 3.15 cm (Interquartile range 2.2-4. 0). Only 5 cases (5.6%) were intrasellar, the other 85 cases (94.4%) had suprasellar (75 cases, 83%) and/or parasellar (32 cases, 35.6%) extension. Necrosis/cystic changes on MRI were present in 24 cases (26.7%). TSS was performed in 86 cases (95.6%) and transcranial surgery in 4 (4.4%) cases. The surgeries were complicated by transient central DI in 21 cases (23.3%), permanent CDI in 6 cases (6.7%), CSF leak in 8 cases (9%), bleeding in 2 (2.2%), stroke in 3 (3.3%) and partial or panhypopituitarism in 58 cases (64.4%). Twenty-two (24.4%) patients underwent a second TSS, 6 (6.7%) transcranial surgery, 32 (35.6%) external radiotherapy. At a median follow-up of 8.5 years (IQ range 4.63-12.18), only 19 (21%) patients had no evidence of residual tumor on follow-up MRI. The other 71 (79%) cases continued to have evidence of residual tumor, either completely intrasellar in 30 (33.3%) cases or with the suprasellar or parasellar residual component in 41 (45.6%) cases. Conclusions Non-functioning PA and other non-pituitary sellar tumors constitute 50% of sellar masses. Most are non-functioning PA, but atypical PA and other non-PA tumors can masquerade as PA. Most of these Non-functioning sellar masses are large with supra and parasellar extension. Surgery effectively reduces tumor size but is rarely curative and frequently complicated by hypopituitarism of variable severity and local complications. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

Giant Cell Tumor in Axial Skeleton With Neurologic Symptoms

A healthy 34-year-old man exhibited progressive lower-extremity numbness and weakness. Computed tomography revealed a mass compressing the thoracic spine with associated pathologic fracture. Biopsy showed findings compatible with giant cell tumor of the bone, and H3F3A gene mutation testing confirmed the diagnosis present in the axial skeleton. He was successfully managed with T3–T7 fusion, T5 corpectomy, and physical therapy. This case highlights an atypical presentation of an uncommon neoplasm with associated neurologic deficits.

GIANT CELL TUMOUR OF HAND: A CASE REPORT

Giant cell tumours commonly occur at the metaphysis-epiphysis region of long bones especially the distal femur. Giant-cell tumor (GCT) of the bone affecting the hand is a rare lesion that is usually diagnosed at an advanced stage and has a high rate of recurrence. These tumors are mostly benign ,multifocal. It is composed of three cell types: the neoplastic GCT stromal cells; mononuclear monocyte cells; and multinucleated giant cells. Clinical imaging is basic for the diagnosis of a GCT. We are presenting a case report of a 28 years old male, who presented with a swelling in right ring nger, following trauma. X-ray showed destructive expansile lytic lesion of the middle phalanx of right ring nger. CT also showed expansile lytic lesion with ballooning of cortex involving middle phalanx with sparing the neck of phalanx. FNAC of the swelling was done and it revealed a typical benign giant cell tumor composed of closely packed stromal cells with admixture of evenly distributed giant cells.

Giant cell tumor of the bone of maxillary sinus: A rare uncommon manifestation implicated in a new mosaic of disorders?

The goal is to show a rare case of Giant Cell Tumor of Bone in the maxillary sinus implicated in a process coincidentally or casually with another type of lesion primarily developed. A 33-year-old male patient attended a surgical service, presenting swelling, obstruction and firm mass externalizing through the right nostril and perceived during 6 months. During the anamnesis, the patient stated to been underwent an incisional biopsy 4 years ago of a tumor with histopathological diagnosis of the Nasal Paraganglioma, however the immunohistochemical study was negative for this tumor. During the Computed Tomography evaluate was observed a hyperdense mass occupying the entire maxillary sinus. In the Nuclear Magnetic Resonance evaluation, it was showed a hypersignal image in the entire maxillary sinus, invading the nasal cavity and portion of skull base. A bone window was performed in the right maxillary sinus and excisional biopsy was made. In the new histopathological examination, the diagnose was consistent with Giant Cell Tumor of Bone, being observed a large number of multinucleated giant cells, some with disorganized nuclei and others similar to Touton giant cells. A large proliferation of xanthomatous-looking cells was also observed without features of malignity. At the 3-year follow-up, the patient reported no complications such as facial paralysis, infection, relapse or spread. The association between lesions occurring in the same location requires further study, possibly implicated in a new model of clinical, microscopic, and genetic disorders. Thus, masses originating from chronic inflammatory tissue may have the potential to transform into GCTB?

Giant cell tumor of the bone: an evaluation of prognostic factors associated with local recurrence and a comparison with the current literature

Aim: Results of the surgical and medical treatments of giant cell tumor of the bone (GCT) in terms of local recurrence and prognostic factors associated with local recurrence are evaluated in this study. Material and Method: Patients treated with either surgical or medical methods for GCT between 2011 and 2021 were retrospectively evaluated. Gender and age of the patients, localization of tumors, the existence of pathological fractures, grade of the tumor, soft tissue expansion, and resection types were evaluated. Postoperative local recurrence and metastasis were analyzed, and the risk factors associated with local recurrence were determined. Results: The mean age of the 117 patients (51 female and 66 male) was 36.1±9.3 years. The mean follow-up was 71.2±48.3 months. Forty patients were Grade I, 56 were Grade II, and 21 were Grade 3, according to the Campanacci Grading System. Soft tissue expansion was present in 21 (17.9%) patients. 59.8% of the patients were undergone intralesional curettage, 32.4% of the patients were treated with marginal or wide local excision combined with adjuvant therapy with liquid nitrogen and poly-methyl methacrylate (PMMA) application, and 5.9% of the patients have treated with en bloc wide resection and reconstruction or arthrodesis. Two patients suffering from sacral involvement were treated with radiotherapy. There was local recurrence after surgery in 19 (16.2%) of the patients. Conclusion: Local recurrence is an important cause of morbidity in the treatment of GCT, which is a benign but aggressive tumor of the bone. In this study, in which we investigated the causes of local recurrence, Campanacci Grade and soft tissue expansion were found to be associated with the development of local recurrence.

Case Report On Giant Cell Tumour In Distal End Of Radius Left Side Managed With Chemical Cauterization And Bone Grafting

Giant cell tumour of the bone is a regionally assertive neoplasm that is implemented in practice with elongated curettage andtherapeutic interventions, which would be having lesser risk of recurrence. The skeletal tumour is a single, non malignant, butregionally assertive cancer. In the fully grown skeleton, it most frequently affects the epiphysis region of bones. This is mostcommon in the femur, tibia and lower end of radius. Lower end of radius tumour makes up of about 10 percent of overall bonytumours. The obliteration of osseous and cartilages in the proximal distal radius giant cell tumour cells makes salvaging the forearmjoint morphology and feature difficult. Numerous techniques are given, such as wide excision and allograft rebuilding or ulnacentralized control with wrist fusion. We reveal, outcomes of a lower end of radius tumour adequately treated with chemicalcauterization and bone grafting, to retain forearm and hand degree of freedom and supination with better functional recovery.

Effect of bisphosphonates on bone giant cell tumor recurrence: a meta-analysis

BackgroundWe examined the impact of bisphosphonates as adjuvant therapy on the recurrence of giant cell bone tumors and the impact of various tumor stages and surgical techniques on this effect. Following a thorough examination of the literature up to January 2022, 10 studies including 601 adults with giant cell tumors of the bone were reported; 295 of these subjects received bisphosphonates as adjuvant therapy following surgery, and 306 served as the control group. To examine the possibility of lowering the recurrence of giant cell bone tumors, a comparison between bisphosphonates and a control group was made. In order to evaluate the impact of bisphosphonates as adjuvant therapy on the recurrence of the giant cell bone tumor, odds ratios (OR) with 95% confidence intervals (CIs) were determined. Additionally, the dichotomous technique with a random or fixed-effect model was used to examine the effects of various tumor stages and pertinent surgical procedures.ResultsPatients with giant cell tumors of the bone who received bisphosphonates as adjuvant therapy had significantly lower postoperative recurrence rates outcomes in all subjects with giant cell tumor of bone (OR 0.19; 95% CI 0.12–0.31, p = 0.001), patients with stage I–II giant cell tumors of the bone (OR 0.29; 95% CI 0.11–0.76, p = 0.01), patients with stage III giant cell tumors of the bone (OR 0.17; 95% CI 0.07–0.42, p < 0.001); and post-intralesional curettage (OR 0.18; 95% CI 0.06–0.49, p < 0.001) compared to control. Bisphosphonates were used in participants with giant cell tumors of the bone after broad excision, but there was no discernible difference between the two groups in terms of postoperative recurrence outcomes (OR 0.66; 95% CI 0.11–3.91, p = 0.65).ConclusionsIn patients with giant cell tumors of the bone after intralesional curettage, the use of bisphosphonates as adjuvant therapy may lower the incidence of postoperative recurrence outcomes, but no appreciable difference was identified after extensive resection. According to the observed relationship, using bisphosphonates is advised to lower the likelihood of postoperative recurrence that can happen in patients with giant cell tumors of the bone.

Primary hyperparathyroidism-induced brown tumors caused by parathyroid carcinoma: a case report and literature review

Brown tumors represent a benign disease that is induced by primary or secondary hyperparathyroidism, with the pathological feature of osteitis fibrosa cystica. Primary hyperparathyroidism caused by parathyroid carcinoma resulting in brown tumors is extremely rare. Herein, we report the case of a 60-year-old male patient who was admitted for giant cell tumors of the bone with local pain and limited movement of the left knee joint. With early detection of multifocal osteolytic bone lesions, hyperparathyroidism (parathyroid hormone: 2365.00 pg/mL), and parathyroid cancer, the diagnosis of brown tumors was confirmed without any unnecessary or harmful interventions. Thereafter, he underwent parathyroidectomy, from which postoperative pathology confirmed parathyroid carcinoma, and total knee arthroplasty to restore movement of the knee joint. Seven months after surgery, the left knee joint had good range of movement. This case emphasizes that detecting patients’ parathyroid hormone levels should not be neglected when diagnosing multifocal osteolytic bone lesions. A comprehensive analysis combining clinical symptoms, imaging, and laboratory tests is conducive to accurate disease assessments and avoiding unnecessary or even survival-impairing surgery. However, when the tumor involves a large joint or seriously affects joint movement, surgery may be worth considering.