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European Spine Journal

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01-07-2018 | Case Report

Neoadjuvant denosumab for the treatment of a sacral osteoblastoma

Authors: Jeremy J. Reynolds, Dominique A. Rothenfluh, Nick Athanasou, Shaun Wilson, David C. Kieser

Published in: European Spine Journal | Special Issue 3/2018

Abstract

Purpose

To present a case of aggressive sacral osteoblastoma (OB) treated with neoadjuvant denosumab therapy and en bloc resection.

Methods

Case report of a 14-year-old male with an aggressive OB affecting the superior articular process of the left first sacral segment. The lesion was lytic and metabolically active and involved the left-sided posterior elements of S1–S3 with extension into the spinal canal, affecting the left S1, S2, S3, S4 and S5 nerve roots. He was treated for 1 month with neoadjuvant denosumab followed by en bloc resection.

Results

Denosumab therapy caused regression of the tumour and converted the diffuse infiltrative mass into a well-defined solid (osteoma-like) structure, aiding surgical resection and preserving the S1, S4 and S5 nerve roots. Histologically, the treated lesion showed abundant sclerotic woven bone and osteoblasts with absence of osteoclasts.

Conclusions

A short course of denosumab caused tumour regression, ossification and conversion of an aggressive OB into a sclerotic, well-defined lesion thus aiding surgical resection and preservation of neural structures. Neoadjuvant therapy reduced osteoclast numbers but PET showed that the lesion remained FDG avid post-therapy.

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Title: Neoadjuvant denosumab for the treatment of a sacral osteoblastoma
Authors: Jeremy J. Reynolds
Dominique A. Rothenfluh
Nick Athanasou
Shaun Wilson
David C. Kieser
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue Special Issue 3/2018
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-018-5461-z

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Neoadjuvant denosumab for the treatment of a sacral osteoblastoma

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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