Artikel
Therapeutic management of a substantial pelvic aneurysmatic bone cyst including the off lable use of denosumab in a 35 years old female patient
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Autoren
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Dimitris Ntalos
- Universitätsklinikum Hamburg Eppendorf, Zentrum für operative Medizin, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Hamburg, Germany
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Matthias Priemel
- Universitätsklinikum Hamburg Eppendorf, Zentrum für operative Medizin, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Hamburg, Germany
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Carsten Schlickewei
- Universitätsklinikum Hamburg Eppendorf, Zentrum für operative Medizin, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Hamburg, Germany
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Johannes M. Rueger
- Universitätsklinikum Hamburg Eppendorf, Zentrum für operative Medizin, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Hamburg, Germany
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Alexander Spiro
- AKK Altonaer Kinderkrankenhaus gGmbH , Kinderorthopädie, Hamburg, Germany
| Veröffentlicht: | 23. Oktober 2017 |
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Gliederung
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Objectives: Aneurysmal bone cysts (ABC) are benign bone tumors which are highly vascularized. The main course of treatment is curettage followed by bone grafting or cement insertion. Still recurrence remains a main problem for patients. Denosumab is a monoclonal antibody which acts as an inhibitor of the RANK/RANKL pathway, diminishing bone turnover. Recent case reports have shown that Denosumab can be a promising therapeutic agent for people suffering from therapy-resistant ABC
Methods: We report the case of a 35 year old female patient presenting with a pronounced ABC of the pelvis. Since the tumor was inoperable, Denosumab was administered, leading to a significant shrinkage of the lesion which allowed surgical intervention. Upon recurrence, Denosumab was restarted putting the patient once more into remission. Follow up was four years overall with a clinical and radiological stable disease for fifteen months after final discontinuation of the monoclonal antibody.
Results and Conclusion: In conclusion Denosumab seems to be a promising new treatment alternative in ABC, especially in patients where surgical resection is no option and in relapsing patients where potential physical disabilities can thus be evaded.
