title: Giant Cell Tumor of Cervical Spine Presenting as Acute Asphyxia: Successful Surgical Resection After Down-Staging With Denosumab.
abstract: METHODS
  Case report and literature review.
  
  
  OBJECTIVE
  To describe treatment of a unique case of acute airway obstruction by a large C7 giant cell tumor (GCT) with preoperative denosumab followed by surgical resection, and review the literature on this rare entity.
  
  
  BACKGROUND
  Standard treatment for GCTs includes surgical resection or curettage and packing. Large lesions in the spine may require preoperative therapy with denosumab, a human monoclonal antibody to RANKL, to facilitate surgery. It is highly unusual for GCT arising in cervical spine to present with acute asphyxia (requiring tracheostomy).
  
  
  METHODS
  We report a patient with large C7 GCT that caused tracheal compression with almost complete airway obstruction requiring emergency intubation.
  
  
  RESULTS
  The tumor responded to subcutaneously administered denosumab with marked decrease in size and relief of symptoms. Increased tumor mineralization in response to therapy facilitated subsequent successful surgical tumor resection. The patient remains symptom-free 2 years after surgery without tumor recurrence.
  
  
  CONCLUSIONS
  Denosumab can shrink the size of large GCTs, providing symptom relief before surgery and facilitate tumor resection.
  
  
  METHODS
  5.
authors: Department of Diagnostic Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors: Rajendra
authors: R
authors: Kumar
authors: Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors: Jeanne M
authors: JM
authors: Meis
authors: Department of Diagnostic Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors: Behrang
authors: B
authors: Amini
authors: Department of Diagnostic Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors: Kevin W
authors: KW
authors: McEnery
authors: Department of Diagnostic Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors: John E
authors: JE
authors: Madewell
authors: Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors: Laurence D
authors: LD
authors: Rhines
authors: Department of Sarcoma Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors: Robert S
authors: RS
authors: Benjamin
mesh_terms: D000328:Adult; D001237:Asphyxia / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D001859:Bone Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D003475:Curettage / Q000379:methods; D000069448:Denosumab / Q000627:therapeutic use*; D018212:Giant Cell Tumor of Bone / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D013131:Spine / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000069448:Denosumab