Denosumab salvage therapy in a patient with a locally advanced and refractory sellar giant cell tumour of bone.,The Lancet Diabetes & Endocrinology

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Denosumab salvage therapy in a patient with a locally advanced and refractory sellar giant cell tumour of bone.
The Lancet Diabetes & Endocrinology ( IF 44.0 ) Pub Date : 2020-02-11 , DOI: 10.1016/s2213-8587(20)30041-3
Pedro Marques ₁ , Natasha M Appelman-Dijkstra ₁ , Hans Gelderblom ₂ , Mark C Kruit ₃ , Wouter R van Furth ₄ , Alberto M Pereira ₁ , Nienke R Biermasz ₁

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A 41-year-old man presented with a 2-month history of progressive vision loss and headaches. MRI revealed a large sellar tumour with suprasellar extension, which was deemed a probable pituitary macroadenoma (). The patient underwent transsphenoidal surgery because of visual field defects and headaches. Histological analysis after surgery revealed a giant cell tumour of bone (GCTB) and symptoms improved; however, 2 months later the large sellar–clival remnant compressing the optic chiasm () motivated a second surgery by pterional craniotomy. After surgery, tumour regrowth occurred (), causing diplopia and blurred vision. A third decompressing operation aiming for maximal debulking before denosumab commencement was done endoscopically; however, only partial tumour removal was achieved (). Denosumab (120 mg subcutaneously every 28 days) was initiated, and a marked response was noted after 6 months of treatment (). After 14 months of denosumab, the patient remained symptom-free without needing further operations ().

中文翻译：

Denosumab挽救疗法用于患有局部晚期难治性蝶鞍巨细胞瘤的患者。

一名41岁的男子有2个月的进行性视力减退和头痛病史。MRI揭示了一个大型的鞍状肿瘤，具有上鞍延伸，被认为是可能的垂体巨腺瘤（）。由于视野缺损和头痛，该患者接受了蝶窦手术。手术后的组织学分析显示骨巨细胞瘤（GCTB），症状得到改善；然而，两个月后，巨大的鞍状-腹底残余物压迫了视交叉膜，开始了第二次开颅手术。手术后，发生肿瘤再生长（），引起复视和视力模糊。在内窥镜下开始地诺单抗开始前的第三次减压操作，旨在最大程度地减量化；但是，仅实现了部分肿瘤切除（）。开始使用Denosumab（每28天皮下注射120 mg），治疗6个月后观察到明显的反应（）。地诺单抗治疗14个月后，患者无症状，无需进一步手术（）。

更新日期：2020-03-19

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