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Treatment and outcome of malignant giant cell tumor in the spine

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Abstract

Malignant giant cell tumor (MGCT) in the spine is extremely rare and there is little published information regarding this subject in the literature. We attempted to correlate different treatment options and outcomes over time. A retrospective study of patients with spinal MGCT who were surgically treated in our center between 2006 and 2012 was performed. Overall, three surgical management strategies, including subtotal resection, piecemeal total resection, and total en bloc spondylectomy were applied. Postoperative radiotherapy was carried out in 4 cases. Clinical data and efficacy of surgical treatment strategy were analyzed via chart review. A total of 14 patients with spinal MGCT were included in the study. Three cases were diagnosed as primary MGCT (PMGCT), while the other 11 patients were secondary MGCT (SMGCT). The mean follow-up period was 41 (range 3–75) months. Recurrence was found in 7 patients after surgery in our center, while distant metastasis and death occurred in 4 and 6 cases, respectively. MGCT of bone is always a high-grade sarcoma with a poor prognosis and complete excision, while also preserving neural function, is recommended. In our study, patients who underwent total en bloc spondylectomy had significantly lower local recurrence rate for MGCT in the spine.

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References

  1. Xu W, Li X, Huang W et al (2013) Factors affecting prognosis of patients with giant cell tumors of the mobile spine: retrospective analysis of 102 patients in a single center. Ann Surg Oncol 20(3):804–810

    Article  PubMed  Google Scholar 

  2. Wu Z, Yin H, Liu T et al (2014) MiR-126-5p regulates osteoclast differentiation and bone resorption in giant cell tumor through inhibition of MMP-13. Biochem Biophys Res Commun 443(3):944–949

    Article  CAS  PubMed  Google Scholar 

  3. Werner M (2006) Giant cell tumour of bone: morphological, biological and histogenetical aspects. Int Orthop 30(6):484–489

    Article  PubMed Central  PubMed  Google Scholar 

  4. Junming M, Cheng Y, Dong C et al (2008) Giant cell tumor of the cervical spine: a series of 22 cases and outcomes. Spine (Phila Pa 1976) 33(3):280–288

    Article  Google Scholar 

  5. Wu Z, Yang X, Xiao J et al (2011) Aneurysmal bone cyst secondary to giant cell tumor of the mobile spine: a report of 11 cases. Spine (Phila Pa 1976) 36(21):E1385–E1390

    Article  Google Scholar 

  6. Rock MG, Sim FH, Unni KK et al (1986) Secondary malignant giant-cell tumor of bone. Clinicopathological assessment of nineteen patients. J Bone Jt Surg Am 68(7):1073–1079

    CAS  Google Scholar 

  7. Bertoni F, Bacchini P, Staals EL (2003) Malignancy in giant cell tumor of bone. Cancer 97(10):2520–2529

    Article  PubMed  Google Scholar 

  8. Dahlin DC, Cupps RE, Johnson EW Jr (1970) Giant-cell tumor: a study of 195 cases. Cancer 25(5):1061–1070

    Article  CAS  PubMed  Google Scholar 

  9. Reid R, Banerjee SS, Sciot R (2002) Giant cell tumour. In: Fletcher CDM, Unni KK, Mertens F (eds) World health organization classification of tumours: pathology and genetics of tumours of soft tissue and bone. IARC Press, Lyon, pp 309–314

    Google Scholar 

  10. Domovitov SV, Healey JH (2010) Primary malignant giant-cell tumor of bone has high survival rate. Ann Surg Oncol 17(3):694–701

    Article  PubMed  Google Scholar 

  11. Gong L, Liu W, Sun X et al (2012) Histological and clinical characteristics of malignant giant cell tumor of bone. Virchows Arch 460(3):327–334

    Article  CAS  PubMed  Google Scholar 

  12. Sakkers RJ, van der Heul RO, Kroon HM et al (1997) Late malignant transformation of a benign giant-cell tumor of bone. A case report. J Bone Jt Surg Am 79(2):259–262

    CAS  Google Scholar 

  13. Mori Y, Tsuchiya H, Karita M et al (2000) Malignant transformation of a giant cell tumor 25 years after initial treatment. Clin Orthop Relat Res 381:185–191

    Article  PubMed  Google Scholar 

  14. Marui T, Yamamoto T, Yoshihara H et al (2001) De novo malignant transformation of giant cell tumor of bone. Skelet Radiol 30(2):104–108

    Article  CAS  Google Scholar 

  15. Unni KK (1996) Dahlin’s bone tumors-general aspects and data on 11,087 cases, 5th edn. Lippincott-Raven Publishers, Philadelphia, pp 263–287

    Google Scholar 

  16. Hutter RV, Worcester JN Jr, Francis KC et al (1962) Benign and malignant giant cell tumors of bone. A clinicopathological analysis of the natural history of the disease. Cancer 15:653–690

    Article  CAS  PubMed  Google Scholar 

  17. Frankel HL, Hancock DO, Hyslop G et al (1969) The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia, I. Paraplegia 7(3):179–192

    Article  CAS  PubMed  Google Scholar 

  18. Enneking WF (1986) A system of staging musculoskeletal neoplasms. Clin Orthop Relat Res 204:9–24

    PubMed  Google Scholar 

  19. Boriani S, Weinstein JN, Biagini R (1997) Primary bone tumors of the spine. Terminology and surgical staging. Spine (Phila Pa 1976) 22(9):1036–1044

    Article  CAS  Google Scholar 

  20. Yin H, Zhou W, Meng J et al (2014) Prognostic factors of patients with spinal chondrosarcoma: a retrospective analysis of 98 consecutive patients in a single center. Ann Surg Oncol 21:3572–3578

    Article  PubMed  Google Scholar 

  21. Yin H, Zhou W, Yu H et al (2014) Clinical characteristics and treatment options for two types of osteoblastoma in the mobile spine: a retrospective study of 32 cases and outcomes. Eur Spine J 23(2):411–416

    Article  PubMed Central  PubMed  Google Scholar 

  22. Yin H, Zhang D, Wu Z et al (2013) Desmoplastic fibroma of the spine: a series of 12 cases and outcomes. Spine J. doi:10.1016/j.spinee.2013.09.042

    Google Scholar 

  23. Boriani S, Sudanese A, Baldini N et al (1986) Sarcomatous degeneration of giant cell tumours. Ital J Orthop Traumatol 12(2):191–199

    CAS  PubMed  Google Scholar 

  24. Gitelis S, Wang JW, Quast M et al (1989) Recurrence of a giant-cell tumor with malignant transformation to a fibrosarcoma twenty-five years after primary treatment. A case report. J Bone Jt Surg Am 71(5):757–761

    CAS  Google Scholar 

  25. Kenan S, Abdelwahab IF, Klein MJ et al (1995) Case report 863. Osteosarcoma associated with giant cell tumor. Skelet Radiol 24(1):55–58

    Article  CAS  Google Scholar 

  26. Ortiz-Cruz EJ, Quinn RH, Fanburg JC et al (1995) Late development of a malignant fibrous histiocytoma at the site of a giant cell tumor. Clin Orthop Relat Res 318:199–204

    PubMed  Google Scholar 

  27. Zhu XZ, Steiner GC (1990) Malignant giant cell tumor of bone: malignant transformation of a benign giant cell tumor treated by surgery. Bull Hosp Jt Dis Orthop Inst 50(2):169–176

    CAS  PubMed  Google Scholar 

  28. Sanerkin NG (1980) Malignancy, aggressiveness, and recurrence in giant cell tumor of bone. Cancer 46(7):1641–1649

    Article  CAS  PubMed  Google Scholar 

  29. Nascimento AG, Huvos AG, Marcove RC (1979) Primary malignant giant cell tumor of bone: a study of eight cases and review of the literature. Cancer 44(4):1393–1402

    Article  CAS  PubMed  Google Scholar 

  30. Rao G, Suki D, Chakrabarti I et al (2008) Surgical management of primary and metastatic sarcoma of the mobile spine. J Neurosurg Spine 9(2):120–128

    Article  PubMed  Google Scholar 

  31. Mendenhall WM, Zlotecki RA, Scarborough MT et al (2006) Giant cell tumor of bone. Am J Clin Oncol 29(1):96–99

    Article  PubMed  Google Scholar 

  32. Beebe-Dimmer JL, Cetin K, Fryzek JP et al (2009) The epidemiology of malignant giant cell tumors of bone: an analysis of data from the Surveillance, Epidemiology and End Results Program (1975–2004). Rare Tumors 1(2):e52

    PubMed Central  PubMed  Google Scholar 

  33. Boriani S, Bandiera S, Donthineni R et al (2010) Morbidity of en bloc resections in the spine. Eur Spine J 19(2):231–241

    Article  PubMed Central  PubMed  Google Scholar 

  34. Bandiera S, Boriani S, Donthineni R et al (2009) Complications of en bloc resections in the spine. Orthop Clin North Am 40(1):125–131

    Article  PubMed  Google Scholar 

  35. McDonnell MF, Glassman SD, Dimar JR 2nd et al (1996) Perioperative complications of anterior procedures on the spine. J Bone Jt Surg Am 78(6):839–847

    CAS  Google Scholar 

  36. Karamanakos PN, Jaaskelainen JE, Alafuzoff I et al (2010) Malignant giant cell tumor in the posterior fossa of a neonate. J Neurosurg Pediatr 5(3):277–282

    Article  PubMed  Google Scholar 

  37. Sasagawa Y, Tachibana O, Shiraga S et al (2012) Secondary malignant giant cell tumor of the clivus: case report. Clin Neurol Neurosurg 114(6):786–788

    Article  PubMed  Google Scholar 

  38. Kishima H, Miyao Y, Shimizu K (2001) Radiosensitive giant cell tumour of the sphenoid bone. Br J Neurosurg 15(2):171–174

    Article  CAS  PubMed  Google Scholar 

  39. Martins AN, Dean DF (1974) Giant cell tumor of sphenoid bone: malignant transformation following radiotherapy. Surg Neurol 2(2):105–107

    CAS  PubMed  Google Scholar 

  40. Watkins LD, Uttley D, Archer DJ et al (1992) Giant cell tumors of the sphenoid bone. Neurosurgery 30(4):576–581

    Article  CAS  PubMed  Google Scholar 

  41. Yamamoto M, Fukushima T, Sakamoto S et al (1998) Giant cell tumor of the sphenoid bone: long-term follow-up of two cases after chemotherapy. Surg Neurol 49(5):547–552

    Article  CAS  PubMed  Google Scholar 

  42. Anract P, De Pinieux G, Cottias P et al (1998) Malignant giant-cell tumours of bone. Clinico-pathological types and prognosis: a review of 29 cases. Int Orthop 22(1):19–26

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  43. Mahadevan A, Miksad R, Goldstein M et al (2011) Induction gemcitabine and stereotactic body radiotherapy for locally advanced nonmetastatic pancreas cancer. Int J Radiat Oncol Biol Phys 81(4):e615–e622

    Article  CAS  PubMed  Google Scholar 

  44. Campanacci M, Baldini N, Boriani S, Sudanese A (1987) Giant-cell tumor of bone. J Bone Jt Surg Am 69(1):106–114

    CAS  Google Scholar 

Download references

Acknowledgments

This work was supported by the National Natural Science Foundation of China (81402222, 81402223, 81401355).

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    Authors and Affiliations

    1. Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China

      Huabin Yin, Mo Cheng, Bo Li, Tong Meng, Jing Wang, Wang Zhou, Wangjun Yan & Jianru Xiao

    2. Department of Pathology, Changzheng Hospital, Second Military Medical University, Shanghai, China

      Binbin Li

    3. Department of Radiology, Changzheng Hospital, Second Military Medical University, Shanghai, China

      Peng Wang

    4. Department of Orthopedics, 149 Hospital, Lianyungang, Jiangsu, China

      Huabin Yin

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    1. Huabin Yin
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    2. Mo Cheng
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    Correspondence to Wang Zhou, Wangjun Yan or Jianru Xiao.

    Additional information

    Huabin Yin, Mo Cheng, and Bo Li contributed equally to this work, and all should be considered first author.

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    Yin, H., Cheng, M., Li, B. et al. Treatment and outcome of malignant giant cell tumor in the spine. J Neurooncol 124, 275–281 (2015). https://doi.org/10.1007/s11060-015-1835-9

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