Successful Intravascular Correction of Intratumoral Pseudoaneurysm by Erosion of the Aorta in a Patient with Thoracic Giant Cell Tumor of Bone Responding to Denosumab
Giant cell tumor of bone (GCT) is a rare, locally aggressive neoplasm characterized by the presence of giant cells with osteoclast activity. Its biology involves the overexpression of the Receptor Activator of Nuclear Factor kB Ligand (RANKL) by osteoclast-like giant cells and tumor stromal cells, w...
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Wiley
2015-01-01
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Series: | Case Reports in Oncological Medicine |
Online Access: | http://dx.doi.org/10.1155/2015/626741 |
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author | Natalia M. P. Fraile Diego Toloi Ceci O. Kurimori Adriana R. B. Matutino Alberto Codima Veridiana P. Camargo Olavo Feher Rodrigo R. Munhoz |
author_facet | Natalia M. P. Fraile Diego Toloi Ceci O. Kurimori Adriana R. B. Matutino Alberto Codima Veridiana P. Camargo Olavo Feher Rodrigo R. Munhoz |
author_sort | Natalia M. P. Fraile |
collection | DOAJ |
description | Giant cell tumor of bone (GCT) is a rare, locally aggressive neoplasm characterized by the presence of giant cells with osteoclast activity. Its biology involves the overexpression of the Receptor Activator of Nuclear Factor kB Ligand (RANKL) by osteoclast-like giant cells and tumor stromal cells, which has been shown to be an actionable target in this disease. In cases amenable to surgical resection, very few therapeutic options were available until the recent demonstration of significant activity of the anti-RANK-ligand monoclonal antibody denosumab. Here we present a case of a patient with advanced GCT arising in the spine, recurring after multiple resections and embolization. Following initiation of denosumab, which resulted in unequivocal clinical improvement, computed tomography of the chest done for reassessment purposes revealed an intratumoral pseudoaneurysm by erosion of the aorta, further corrected by endovascular approach and stent placement. Patient had an unremarkable recovery from the procedure and continued benefit from therapy with denosumab and remains on treatment 24 months after the first dose. |
format | Article |
id | doaj-art-387c0fc7b0a9440db4494680f19a31f3 |
institution | Kabale University |
issn | 2090-6706 2090-6714 |
language | English |
publishDate | 2015-01-01 |
publisher | Wiley |
record_format | Article |
series | Case Reports in Oncological Medicine |
spelling | doaj-art-387c0fc7b0a9440db4494680f19a31f32025-02-03T05:46:18ZengWileyCase Reports in Oncological Medicine2090-67062090-67142015-01-01201510.1155/2015/626741626741Successful Intravascular Correction of Intratumoral Pseudoaneurysm by Erosion of the Aorta in a Patient with Thoracic Giant Cell Tumor of Bone Responding to DenosumabNatalia M. P. Fraile0Diego Toloi1Ceci O. Kurimori2Adriana R. B. Matutino3Alberto Codima4Veridiana P. Camargo5Olavo Feher6Rodrigo R. Munhoz7Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, BrazilInstituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, BrazilInstituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, BrazilInstituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, BrazilHospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, BrazilInstituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, BrazilInstituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, BrazilInstituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, BrazilGiant cell tumor of bone (GCT) is a rare, locally aggressive neoplasm characterized by the presence of giant cells with osteoclast activity. Its biology involves the overexpression of the Receptor Activator of Nuclear Factor kB Ligand (RANKL) by osteoclast-like giant cells and tumor stromal cells, which has been shown to be an actionable target in this disease. In cases amenable to surgical resection, very few therapeutic options were available until the recent demonstration of significant activity of the anti-RANK-ligand monoclonal antibody denosumab. Here we present a case of a patient with advanced GCT arising in the spine, recurring after multiple resections and embolization. Following initiation of denosumab, which resulted in unequivocal clinical improvement, computed tomography of the chest done for reassessment purposes revealed an intratumoral pseudoaneurysm by erosion of the aorta, further corrected by endovascular approach and stent placement. Patient had an unremarkable recovery from the procedure and continued benefit from therapy with denosumab and remains on treatment 24 months after the first dose.http://dx.doi.org/10.1155/2015/626741 |
spellingShingle | Natalia M. P. Fraile Diego Toloi Ceci O. Kurimori Adriana R. B. Matutino Alberto Codima Veridiana P. Camargo Olavo Feher Rodrigo R. Munhoz Successful Intravascular Correction of Intratumoral Pseudoaneurysm by Erosion of the Aorta in a Patient with Thoracic Giant Cell Tumor of Bone Responding to Denosumab Case Reports in Oncological Medicine |
title | Successful Intravascular Correction of Intratumoral Pseudoaneurysm by Erosion of the Aorta in a Patient with Thoracic Giant Cell Tumor of Bone Responding to Denosumab |
title_full | Successful Intravascular Correction of Intratumoral Pseudoaneurysm by Erosion of the Aorta in a Patient with Thoracic Giant Cell Tumor of Bone Responding to Denosumab |
title_fullStr | Successful Intravascular Correction of Intratumoral Pseudoaneurysm by Erosion of the Aorta in a Patient with Thoracic Giant Cell Tumor of Bone Responding to Denosumab |
title_full_unstemmed | Successful Intravascular Correction of Intratumoral Pseudoaneurysm by Erosion of the Aorta in a Patient with Thoracic Giant Cell Tumor of Bone Responding to Denosumab |
title_short | Successful Intravascular Correction of Intratumoral Pseudoaneurysm by Erosion of the Aorta in a Patient with Thoracic Giant Cell Tumor of Bone Responding to Denosumab |
title_sort | successful intravascular correction of intratumoral pseudoaneurysm by erosion of the aorta in a patient with thoracic giant cell tumor of bone responding to denosumab |
url | http://dx.doi.org/10.1155/2015/626741 |
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