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Case repository| Volume 44, ISSUE 11, P994.e1-994.e6, November 2019

The Use of Denosumab in Osteoblastoma of the Metacarpal

  • Paul Kooner
    Correspondence
    Corresponding author: Paul Kooner, BS, Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, 600 University Ave., Toronto, Ontario M5G 1X5 Canada.
    Affiliations
    Granovsky-Gluskin Division of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada

    Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
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  • Peter Ferguson
    Affiliations
    Granovsky-Gluskin Division of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada

    Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
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Published:March 22, 2019DOI:https://doi.org/10.1016/j.jhsa.2019.02.001
      Osteoblastoma is a benign aggressive primary bone tumor that occasionally presents in the hand. Because surgical treatment remains the mainstay of treatment, there are no established nonsurgical pharmacological options for patients in whom resection is not feasible. Novel therapies, such as denosumab, are currently being investigated in primary bone tumors. We report a case of osteoblastoma of the first metacarpal that was successfully treated with denosumab. The patient showed a rapid and dramatic response to treatment that led to the transformation of a locally destructive tumor into an ossified painless mass, restoring function while avoiding surgery.

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      References

        • Mcleod R.A.
        • Dahlin D.C.
        • Beabout J.W.
        The spectrum of osteoblastoma.
        AJR Am J Roentgenol. 1976; 126: 321-325
        • Lucas D.R.
        • Unni K.K.
        • McLeod R.A.
        • O’Connor M.I.
        • Sim F.H.
        Osteoblastoma: clinicopathologic study of 306 cases.
        Hum Pathol. 1994; 25: 117-134
        • Berberoglu S.
        • Oguz A.
        • Aribal E.
        • Ataoglu O.
        Osteoblastoma response to radiotherapy and chemotherapy.
        Med Pediatr Oncol. 1997; 28: 304-309
        • Miszczyk L.
        • Wozniak G.
        • Spindel J.
        • Walichiewicz P.
        Radiotherapy in the treatment of osteoblastoma—a report of 5 consecutive cases.
        Nowotwory J Oncol. 2004; 54: 31-33
        • Lewiecki E.M.
        Clinical use of denosumab for the treatment of post-menopausal osteoporosis.
        Curr Med Res Opin. 2010; 26: 2807-2812
        • Fizazi K.
        • Lipton A.
        • Mariette X.
        • et al.
        Randomized phase ii trial of denosumab in patients with bone metastases from prostate cancer, breast cancer, or other neoplasms after intravenous bisphosphonates.
        J Clin Oncol. 2009; 27: 1564-1571
        • Rutkowski P.
        • Ferrari S.
        • Grimer R.J.
        • et al.
        Surgical downstaging in an open-label phase II trial of denosumab in patients with giant cell tumor of bone.
        Ann Surg Oncol. 2015; 22: 2860-2868
        • Traub F.
        • Singh J.
        • Dickson B.
        • et al.
        Efficacy of denosumab in joint preservation for patients with giant cell tumor of the bone.
        Eur J Cancer. 2016; 59: 1-12
        • Ueda T.
        • Morioka H.
        • Nishida Y.
        • et al.
        Objective tumor response to denosumab in patients with giant cell tumor of bone: a multicenter phase II trial.
        Ann Oncol. 2015; 26: 2149-2154
        • Rigó I.Z.
        • Røkkum M.
        Not all non-rheumatoid patients are satisfied with thumb metacarpophalangeal joint arthrodesis.
        J Plast Surg Hand Surg. 2013; 47: 144-146
        • Hachisuka Y.
        • Ogino M.
        • Asai H.
        • et al.
        An electron microscopic study on osteoblastoma—ultrastructure and fine localization of alkaline phosphatase [in Japanese].
        Nippon Seikeigeka Gakkai Zasshi. 1992; 66: 1221-1231
        • Kitazawa S.
        • Kitazawa R.
        RANK ligand is a prerequisite for cancer-associated osteolytic lesions.
        J Pathol. 2002; 198: 228-236
        • Gori F.
        • Hofbauer L.C.
        • Dunstan C.R.
        • Spelsberg T.C.
        • Khosla S.
        • Riggs B.L.
        The expression of osteoprotegerin and RANK ligand and the support of osteoclast formation by stromal-osteoblast lineage cells is developmentally regulated.
        Endocrinology. 2000; 141: 4768-4776
        • Takami M.
        • Woo J.T.
        • Nagai N.
        Osteoblastic cells induce fusion and activation of osteoclasts through a mechanism independent of macrophage-colony-stimulating factor production.
        Cell Tissue Res. 1999; 298: 327-334
        • Dougall W.C.
        • Chaisson M.
        The RANK/RANKL/OPG triad in cancer-induced bone diseases.
        Cancer Metastasis Rev. 2006; 25: 541-549
        • Branstetter D.G.
        • Nelson S.D.
        • Manivel J.C.
        • et al.
        Denosumab induces tumor reduction and bone formation in patients with giant-cell tumor of bone.
        Clin Cancer Res. 2012; 18: 4415-4424
        • Lucas D.R.
        Osteoblastoma.
        Arch Pathol Lab Med. 2010; 134: 1460-1466
        • Zhang Y.
        • Ilaslan H.
        • Krishnaney A.A.
        • Bauer T.W.
        Morphological transformation of giant-cell tumor of bone after treatment with denosumab.
        JBJS Case Connect. 2016; 6: e74
        • Papapoulos S.
        • Lippuner K.
        • Roux C.
        • et al.
        The effect of 8 or 5 years of denosumab treatment in postmenopausal women with osteoporosis: results from the freedom extension study.
        Osteoporos Int. 2015; 26: 2773-2783