title: Spondylectomy for Giant Cell Tumor After Denosumab Therapy.
abstract: METHODS
  A case report.
  
  
  OBJECTIVE
  To report a case of the lumbar giant cell tumor (GCT) utilizing a new clinical treatment modality (denosumab therapy), which showed a massive tumor reduction combined with the L4 spondylectomy.
  
  
  BACKGROUND
  There are some controversies about spinal GCT treatments. Denosumab has provided good clinical results in terms of tumor shrinkage, and local control in a short-time follow-up clinical study phase 2, although for spinal lesions, it has not been described. Nonetheless, "en bloc" spondylectomy has been accepted as being the best treatments modalities in terms of oncological control.
  
  
  METHODS
  A case study with follow-up examination and series radiological assessments 6 months after therapy started, followed by a complex spine surgery.
  
  
  RESULTS
  The denosumab therapy showed on the lumbar computed tomography scans follow-up 6 months later, a marked tumor regression around 90% associated to vertebral body calcification, facilitating a successful L4 spondylectomy with an anterior and posterior reconstruction. The patient recovered without neurological deficits.
  
  
  CONCLUSIONS
  A new therapeutic modality for spinal GCT is available and showing striking clinical results; however, it is necessary for well-designed studies to answer the real role of denosumab therapy avoiding or facilitating complex spine surgeries as spondylectomies for spinal GCT.
  
  
  METHODS
  5.
authors.affiliation: *Department of Neuro-Oncology- Araújo Jorge Cancer Hospital, Goiânia, Goiás, Brazil†Department of Neurology (State University of Campinas-SP), Campinas, São Paulo, Brazil‡Department of Neurological surgery of the Alfenas Medical College, Minas Gerais, Brazil§Department of Surgical Oncology Araújo Jorge Cancer Hospital, Goiânia, Goiás, Brazil||Department of Pathology-Araújo Jorge Cancer Hospital, Goiânia, Goiás, Brazil.
authors.forename: Rodrigo Alves
authors.initials: RA
authors.lastname: de Carvalho Cavalcante
authors.forename: Rômulo Alberto
authors.initials: RA
authors.lastname: Silva Marques
authors.forename: Vinicius Gonçalves
authors.initials: VG
authors.lastname: dos Santos
authors.forename: Eduardo
authors.initials: E
authors.lastname: Sabino
authors.forename: Ailton Cabral
authors.initials: AC
authors.lastname: Fraga
authors.forename: Vladimir Arruda
authors.initials: VA
authors.lastname: Zaccariotti
authors.forename: Joao Batista
authors.initials: JB
authors.lastname: Arruda
authors.forename: Yvens Barbosa
authors.initials: YB
authors.lastname: Fernandes
mesh_terms: D000328:Adult; D018286:Carcinoma, Giant Cell / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D003131:Combined Modality Therapy / Q000379:methods; D000069448:Denosumab / Q000008:administration & dosage*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000069448:Denosumab