Experience in Treating a Patient with a Giant Cell Tumor of Complex Localization

Abstract

Giant cell tumor (GCT) of bone is a relatively rare, benign neoplasm characterized by local destructive growth. Also in a small percentage of cases (2–3 %) there is a primary malignant GCT or malignancy during treatment. The tumor has a high risk of local recurrence after primary treatment. Considering most often the epiphyseal and metaepiphyseal lesions, the tumor is characterized by a high risk of pathological fracture, and leads to damage to the joint and disruption of its function. Difficulty in treatment arises with GCT of complex localization of the pelvic bones, spine, and skull bones. Considering the high risks of surgical treatment, the option of conservative long-term targeted therapy with denosumab is proposed in order to stabilize the process. This article highlights a clinical case of treatment and observation of a patient with pelvic localization of the primary process. During treatment, the patient completely regained weight bearing ability and quality of life. Denosumab is becoming a good option in the treatment of giant cell bone tumors of complex localization. Drug treatment with proper patient support is an alternative method of treating patients if it is possible to avoid unnecessarily aggressive surgical tactics in order to preserve the patient’s quality of life.