Asunto(s)
Proteína del Grupo de Complementación N de la Anemia de Fanconi/genética , Tumores de Células Gigantes/secundario , Mutación , Órbita/patología , Neoplasias Orbitales/genética , Neoplasias de los Tejidos Blandos/diagnóstico , Adulto , Biopsia , Análisis Mutacional de ADN , ADN de Neoplasias/análisis , Proteína del Grupo de Complementación N de la Anemia de Fanconi/metabolismo , Femenino , Tumores de Células Gigantes/diagnóstico , Tumores de Células Gigantes/metabolismo , Humanos , Imagen por Resonancia Magnética , Metástasis de la Neoplasia , Neoplasias Orbitales/metabolismo , Neoplasias Orbitales/patología , Neoplasias de los Tejidos Blandos/genética , Neoplasias de los Tejidos Blandos/metabolismoRESUMEN
BACKGROUND: Denosumab is a human monoclonal antibody that has been used successfully in the treatment of giant cell tumors of bone. These tumors are rare and, in principle, benign, but they are highly aggressive, locally advanced, osteolytic bone tumors that can metastasize to the lungs. Denosumab is an effective treatment when these tumors cannot be surgically removed or when surgical resection is likely to lead to severe morbidity (eg, loss of limbs or joints). The aim of this systematic review and meta-analysis was to investigate patients with giant cell tumors of bone who experienced tumor progression during treatment with denosumab and to compare them with patients who experienced reduction of their giant cell tumors of bone during treatment with denosumab. METHODS: Embase, Cochrane Library, and MEDLINE/PubMed databases were searched for trials submitted by January 7, 2020, that reported the efficacy and safety of denosumab in patients with giant cell tumors of bone. RESULTS: Sixty studies were reviewed, involving a total of 1074 patients who had giant cell tumors of bone and were treated with denosumab. Of the 60 studies, 58% of the patients were from case series studies, 39% from open-label phase II studies, and 3% from case reports. The response rate for denosumab as a treatment for giant cell tumors of bone was 97.5%, with statistical significance (P < .0001). Pain in the limbs was statistically the most common adverse event for denosumab treatment in case series studies (P < .0001). No treatment-related deaths occurred in the reviewed studies. CONCLUSION: Cumulative evidence supports the addition of surgery to optimal medical therapy with denosumab to reduce tumor size, clinical symptoms, and mortality among patients with giant cell tumors of bone.
Asunto(s)
Neoplasias Óseas/terapia , Denosumab/administración & dosificación , Tumores de Células Gigantes/terapia , Neoplasias Pulmonares/terapia , Recurrencia Local de Neoplasia/epidemiología , Biopsia , Neoplasias Óseas/diagnóstico , Neoplasias Óseas/mortalidad , Neoplasias Óseas/patología , Huesos/diagnóstico por imagen , Huesos/efectos de los fármacos , Huesos/patología , Huesos/cirugía , Quimioterapia Adyuvante/métodos , Legrado , Supervivencia sin Enfermedad , Tumores de Células Gigantes/mortalidad , Tumores de Células Gigantes/secundario , Humanos , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/secundario , Terapia Neoadyuvante/métodos , Recurrencia Local de Neoplasia/prevención & control , Osteotomía , Carga Tumoral/efectos de los fármacosAsunto(s)
Tumores de Células Gigantes/patología , Neoplasias Pulmonares/patología , Anciano de 80 o más Años , Resultado Fatal , Tumores de Células Gigantes/química , Tumores de Células Gigantes/secundario , Humanos , Neoplasias Pulmonares/química , Masculino , Neumonectomía/efectos adversos , Complicaciones Posoperatorias/patologíaRESUMEN
Diffuse giant cell tumours of the tendon sheaths are described in the literature as locally aggressive soft-tissue tumours. We report the case of a 56-year-old male with a history of multiple surgical procedures for a giant cell tumour of the fibular tendon sheath at the right ankle. The multiple recurrences prompted monitoring by positron-emission tomography, which showed lung tumours. Biopsies confirmed that the tumours were metastases from the giant cell tumour of the tendon sheath. In patients with recurrent and/or diffuse giant cell tumour, positron-emission tomography is an effective monitoring tool.
Asunto(s)
Tumores de Células Gigantes/secundario , Neoplasias Pulmonares/secundario , Recurrencia Local de Neoplasia/cirugía , Neoplasias de los Tejidos Blandos/patología , Tobillo , Articulación del Tobillo , Tumores de Células Gigantes/cirugía , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de los Tejidos Blandos/cirugía , TendonesAsunto(s)
Tumores de Células Gigantes/radioterapia , Inmunidad Celular/efectos de la radiación , Inflamación/etiología , Radioterapia/efectos adversos , Adulto , Tumores de Células Gigantes/inmunología , Tumores de Células Gigantes/secundario , Humanos , Inmunidad Celular/inmunología , Inflamación/patología , Masculino , Pronóstico , Adulto JovenRESUMEN
Diffuse-type tenosynovial giant cell tumor (D-TGCT) is a relatively rare mesenchymal tumor. It is a locally aggressive but virtually nonmetastasizing neoplasm and thus regarded as benign. Only a few D-TGCTs with benign histology have been reported to metastasize. We report an extremely rare case of benign D-TGCT in which multiple metastases developed 9 years after surgery for the primary tumor. The present case suggests that conventional D-TGCT has the potential to form distant metastases, albeit exceptionally rarely, and that this probable implantation phenomenon can be managed conservatively.
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Tumores de Células Gigantes/secundario , Rodilla/patología , Neoplasias Pulmonares/secundario , Metástasis Linfática/patología , Neoplasias de los Tejidos Blandos/patología , Membrana Sinovial/patología , Tendones/patología , Adulto , Humanos , MasculinoRESUMEN
Malignant diffuse-type tenosynovial giant cell tumor (D-TSGCT) is an unusual sarcoma. We report a case of malignant D-TSGCT located in the left buttock. A 58-year old woman noticed a small mass at her left buttock 3 months previously. The mass tended to enlarge rapidly, and became 6 cm in diameter. Tumor resection was performed. Grossly, the tumor showed a solid growth pattern and whitish appearance with hemorrhage and necrosis. Microscopically, the tumor was composed of a proliferation of short spindle and oval mononucleated cells with numerous osteoclast-like multinucleated giant cells, which occasionally showed coagulative necrosis. In addition, tumor cells had high mitotic activity and atypical mitoses. Immunohistochemically, the mononucleated cells were positive for CD163 and focally positive for CD68 (clone KP-1 and PG-M1), CD4, smooth muscle actin and S100 protein. Osteoclast-like multinucleated giant cells were positive for CD68 (clone KP-1 and PG-M1) and CD4. Pulmonary metastases were found 6 months after the operation. These findings indicate that this lesion is consistent with malignant D-TSGCT.
Asunto(s)
Tumores de Células Gigantes/secundario , Células Gigantes/patología , Neoplasias de los Tejidos Blandos/patología , Membrana Sinovial/patología , Tendones/patología , Biomarcadores de Tumor/metabolismo , Nalgas , Femenino , Tumores de Células Gigantes/metabolismo , Tumores de Células Gigantes/cirugía , Células Gigantes/metabolismo , Humanos , Neoplasias Pulmonares/secundario , Persona de Mediana Edad , Osteoclastos/metabolismo , Osteoclastos/patología , Neoplasias de los Tejidos Blandos/metabolismo , Neoplasias de los Tejidos Blandos/cirugía , Membrana Sinovial/metabolismo , Tendones/metabolismo , Resultado del TratamientoAsunto(s)
Tumores de Células Gigantes/secundario , Neoplasias de la Base del Cráneo/secundario , Enfermedades del Nervio Abducens/etiología , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Tronco Encefálico/patología , Transformación Celular Neoplásica , Fosa Craneal Posterior/patología , Trastornos de Deglución/etiología , Resultado Fatal , Tumores de Células Gigantes/patología , Tumores de Células Gigantes/cirugía , Humanos , Inmunohistoquímica , Neoplasias Pulmonares/secundario , Imagen por Resonancia Magnética , Masculino , Paresia/etiología , Sarcoma/patología , Neoplasias de la Base del Cráneo/patología , Neoplasias de la Base del Cráneo/cirugía , Tomografía Computarizada por Rayos XAsunto(s)
Tumores de Células Gigantes/secundario , Neoplasias Pulmonares/secundario , Neoplasias Pancreáticas/patología , Terapia Combinada , Diagnóstico Diferencial , Endoscopía Gastrointestinal , Resultado Fatal , Estudios de Seguimiento , Tumores de Células Gigantes/diagnóstico , Tumores de Células Gigantes/terapia , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/terapia , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/diagnóstico por imagen , Neoplasias Pancreáticas/terapia , Tomografía Computarizada por Rayos XRESUMEN
We report the case of a 7-year-old girl presenting with giant cell tumor (GCT) of the index finger, complicated by lung metastases. Index disarticulation, pulmonary metastasectomy and chemotherapy failed to produce a cure, and the child died at the age of 8 years after 1 year's evolution. The pulmonary metastases were discovered following hypoxia during initial biopsy. A review of the literature shows this observation to be original, in terms of the patient's age and of the location, onset and fatal outcome of metastasis. The hypoxic episode complicating biopsy raises the issue of early screening for lung metastases in GCT. Pulmonary dissemination of GCT is of severe prognosis.
Asunto(s)
Neoplasias Óseas/patología , Dedos/patología , Tumores de Células Gigantes/secundario , Neoplasias Pulmonares/secundario , Neoplasias Óseas/diagnóstico por imagen , Niño , Resultado Fatal , Femenino , Dedos/diagnóstico por imagen , Tumores de Células Gigantes/diagnóstico por imagen , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , RadiografíaRESUMEN
Giant cell malignant fibrous histiocytoma or giant cell tumor of the soft parts (GCTSP) is a rare soft tissue tumor. GCTSP has an unpredictable behavior; the majority of the reported cases showed benign histology and those that showed malignant morphologic features were extremely rare. To the best of our knowledge, GCTSP has never been reported to involve the vulva in the English literature. We report the first case of malignant GCTSP of the vulva. Histologic features and the immunoprofile of the tumor and differential diagnosis are discussed in detail. Although extremely rare, consideration of the potential occurrence of GCTSP in the vulva is recommended to avoid a potential diagnostic pitfall.
Asunto(s)
Tumores de Células Gigantes/secundario , Recurrencia Local de Neoplasia/patología , Neoplasias de la Vulva/patología , Anciano de 80 o más Años , Resultado Fatal , Femenino , Tumores de Células Gigantes/metabolismo , Tumores de Células Gigantes/cirugía , Humanos , Inmunohistoquímica , Neoplasias Pulmonares/secundario , Metástasis Linfática/patología , Recurrencia Local de Neoplasia/metabolismo , Recurrencia Local de Neoplasia/cirugía , Neoplasias de la Vulva/metabolismo , Neoplasias de la Vulva/cirugíaRESUMEN
A 70-year-old man known for recurrent abdominal gastrointestinal stroma tumor presented with a suspicious peritoneal mass demonstrated by an abdominal CT scan. Whole-body PET showed focal FDG uptake in the right hip, whereas the peritoneal mass was FDG negative. Histologic work-up of the PET positive lesion surprisingly revealed a giant cell tumor of the tendon sheath. The benignity of the peritoneal mass was confirmed by its disappearance in repeated CT scans. In general, focally increased FDG uptake should be subject to further investigations, especially in localizations that are not consistent with typical metastatic pathways of the former primary tumor.
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Fluorodesoxiglucosa F18/metabolismo , Tumores del Estroma Gastrointestinal/patología , Tumores de Células Gigantes/metabolismo , Membranas/patología , Tendones/patología , Anciano , Tumores de Células Gigantes/diagnóstico por imagen , Tumores de Células Gigantes/secundario , Humanos , Masculino , Estadificación de Neoplasias , Tomografía de Emisión de Positrones , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Cisplatin-based combination chemotherapy is regarded as standard of care for patients with advanced germ cell tumors. In patients with lung metastases and a high tumor load, an association between induction chemotherapy and the development of a 'tumorassociated' acute respiratory distress syndrome (ARDS) has been hypothesized. CASE REPORT: We report the clinical course of a 19-year-old patient who rapidly developed fatal ARDS during the first cycle of chemotherapy using the PEI regimen (cisplatin, etoposide and ifosfamide) for a metastasized (lung, liver, lymph nodes) germ cell tumor of the testis. CONCLUSION: Further clinical research in order to better define risk factors for developing ARDS in this patient population as well as novel strategies for the prevention and treatment of ARDS in those patients are necessary.
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Cisplatino/administración & dosificación , Cisplatino/efectos adversos , Tumores de Células Gigantes/tratamiento farmacológico , Tumores de Células Gigantes/secundario , Neoplasias Pulmonares/secundario , Síndrome de Dificultad Respiratoria/inducido químicamente , Neoplasias Testiculares/tratamiento farmacológico , Neoplasias Testiculares/secundario , Antineoplásicos/administración & dosificación , Antineoplásicos/efectos adversos , Tumores de Células Gigantes/complicaciones , Humanos , Neoplasias Pulmonares/complicaciones , Masculino , Síndrome de Dificultad Respiratoria/prevención & control , Neoplasias Testiculares/complicaciones , Resultado del Tratamiento , Adulto JovenRESUMEN
A retrospective analysis of all bone tumors accessioned at a large referral center (Instituto Nacional de Rehabilitacion) in Mexico City between 2000 and 2005 is presented. A total of 6216 biopsies and surgical resection specimens were reviewed during this period, of which 566 corresponded to bone tumors. Benign bone tumors accounted for 71.6% of cases and malignant bone tumors for 28.4%. The tumors affected men in 53.7% of cases and women in 46.3% of cases, with an average age at presentation of 25 years. The femur was the most common location of the tumors (39.9%), followed by the tibia (17.7%) and humerus (11.8%). The commonest malignant bone tumors were osteosarcoma (46.6%) and chondrosarcoma (8.7%). Of malignant bone tumors, 18.6% corresponded to metastases of carcinomas from internal organs and 8.1% were multiple myeloma. The most common benign bone tumor was osteochondroma (43.7%) followed by giant cell tumor of bone (14.6%) and enchondroma (10.1%). The age distribution showed a peak in children and adolescents comprised predominantly of benign lesions and a second peak in young adults that corresponded to malignant bone tumors (principally osteosarcoma). Malignant bone tumors most often involved the femur, vertebra, and tibia. Our results parallel the findings previously reported in the world literature and show a similar distribution and epidemiology as in other developed and underdeveloped countries. Geographic location does not appear to represent a risk factor for any particular type of bone tumor and does not affect the age distribution, location, or histopathologic type of the lesions.
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Neoplasias Óseas/epidemiología , Neoplasias Óseas/patología , Condrosarcoma/epidemiología , Condrosarcoma/patología , Osteosarcoma/epidemiología , Osteosarcoma/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias Óseas/secundario , Niño , Preescolar , Condroma/epidemiología , Condroma/patología , Condrosarcoma/secundario , Femenino , Tumores de Células Gigantes/epidemiología , Tumores de Células Gigantes/patología , Tumores de Células Gigantes/secundario , Humanos , Incidencia , Lactante , Masculino , México/epidemiología , Persona de Mediana Edad , Osteocondroma/epidemiología , Osteocondroma/patología , Osteosarcoma/secundario , Derivación y Consulta , Estudios Retrospectivos , Factores de Riesgo , Población UrbanaRESUMEN
Giant cell tumor of soft tissue with low malignant potential (GCT-ST) is a low-grade, primary soft tissue sarcoma with histological and clinical features similar to giant cell tumor of the bone. The main tumor localizations are the extremities, but it may also occur in the head and neck region. GCT-ST shows a recurrence rate of approximately 15%, but it very rarely metastasizes. The risk of cancer development, especially of the skin, is up to fivefold increased in immunosuppressed patients after organ transplantation. The association of sarcomas and immunosuppressive therapy is best known for Kaposi sarcomas, whereas other types of sarcomas are rarely found. We report of a GCT-ST of low malignant potential, which developed under long-term immunosuppression in a patient 12 years after heart transplantation. The tumor presented with an unusual aggressive course and metastatic site: the parotid gland. Therefore, we suggest that in patients with immunosuppression, even low malignant cancerous lesions should be carefully observed, as their local behavior may be aggressive with development of metastasis.
Asunto(s)
Tumores de Células Gigantes/secundario , Huésped Inmunocomprometido , Inmunosupresores/efectos adversos , Neoplasias de la Parótida/secundario , Complicaciones Posoperatorias , Neoplasias de los Tejidos Blandos/patología , Anciano , Tumores de Células Gigantes/inmunología , Tumores de Células Gigantes/cirugía , Trasplante de Corazón , Humanos , Terapia de Inmunosupresión , Inmunosupresores/uso terapéutico , Masculino , Recurrencia Local de Neoplasia , Neoplasias de la Parótida/inmunología , Neoplasias de la Parótida/cirugía , Neoplasias de los Tejidos Blandos/inmunología , Neoplasias de los Tejidos Blandos/cirugíaRESUMEN
Giant cell tumor of soft tissue (GCTST) has gained general acceptance as an uncommon but distinct primary soft tissue tumor since it was first described in 1972. GCTST is predominantly seen in adults and typically shows uniformly dispersed osteoclast-like giant cells admixed with oval to polygonal mononuclear cells. It usually follows a benign clinical course, although the malignant variant has been described in cases in which the mononuclear cells demonstrate obvious dysplastic features. It is still not clear whether the two variants belong to the spectrum of the same tumor. No cytogenetic chromosomal abnormalities have been reported in the literature of GCTST. Interestingly, the osseous counterpart of giant cell tumor, which shares similar histologic features, quite often displays a telomeric association at the cytogenetic level, a finding that has never been reported in GCTST. We report the case of a 12-year-old girl with GCTST of the right leg that metastasized to the lung. Cytogenetic studies from the primary tumor showed the phenomenon of telomeric association involving multiple chromosomes.
Asunto(s)
Tumores de Células Gigantes/genética , Tumores de Células Gigantes/secundario , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/secundario , Neoplasias de los Tejidos Blandos/genética , Neoplasias de los Tejidos Blandos/patología , Niño , Aberraciones Cromosómicas , Femenino , Humanos , Telómero/genéticaRESUMEN
The case of 32 years old patient suffering for giant cell bone tumor of left femur was reported. After surgery (curettage and filling of tumor bed with bone cement followed by arthroplasty), a dissemination to lungs was found. Patient was treated by palliative lungs radiotherapy (10 x 1.1 Gy) and six cycles of chemotherapy (every four weeks) based on cisplatin (35 mg/m2) and doxorubicin (30 mg/m2) obtaining significant regression of metastases. Because of four persistent lung metastases, the extracranial radiosurgery using one fraction of 16 Gy was done.
Asunto(s)
Neoplasias Óseas/patología , Fémur/patología , Tumores de Células Gigantes/secundario , Neoplasias Pulmonares/secundario , Adulto , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/radioterapia , Fémur/diagnóstico por imagen , Fémur/efectos de la radiación , Tumor Óseo de Células Gigantes/diagnóstico por imagen , Tumor Óseo de Células Gigantes/patología , Tumor Óseo de Células Gigantes/radioterapia , Tumores de Células Gigantes/diagnóstico por imagen , Tumores de Células Gigantes/radioterapia , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/radioterapia , Masculino , Neoplasias Primarias Secundarias/diagnóstico por imagen , Neoplasias Primarias Secundarias/radioterapia , Dosificación Radioterapéutica , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: Giant cell tumour of bone with pulmonary metastases is rare. However, some patients die of pulmonary metastases, and histological examination cannot distinguish between benign tumour and malignant metastases. In this study, we present clinical and immunohistochemical findings associated with giant cell tumour of bone with pulmonary metastases. METHODS: Five patients with benign giant cell tumour of bone with pulmonary metastases (one man and 4 women) were studied. Patients' ages ranged between 20 and 23 years (mean age, 21.8 years). Tumours were in the distal femur in 2 cases, and in the proximal tibia, distal tibia, and lumbar spine in one case each. The tissue specimens from primary tumours, recurrent tumours, and pulmonary metastases were studied using immunohistochemical techniques. RESULTS: Three of the 5 primary tumours were of the spontaneous regression or growth cessation type, or the continuously slow-growing type, showing 4.2% to 6.2% of positive cells for Ki-67 after immunohistochemical staining. However, 2 patients with the rapid-growing type of disease died of pulmonary metastases; their primary, recurrent, and metastatic tumour specimens contained 9.0% to 11.5% of positive cells for Ki-67. CONCLUSION: Three of the 5 primary tumours had a benign clinical pattern and immunohistochemistry. Two of the 5 patients died of pulmonary metastases, which had an aggressive clinical pattern and a high prevalence of positive cells in Ki-67. Examination of Ki-67 should be carried out for aggressive type of giant cell tumour.