PMC4873610_01
Plain lateral cervical radiographs before denosumab treatment.. Plain lateral cervical radiographs showing a collapse of the C5 vertebral body, whose posterior wall protruded into the spinal canal.
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C5 vertebral body, whose posterior wall protruded into the spinal canal (Fig. 1). Computed tomography (CT) revealed an expansive osteolytic mass lesion on the C5 vertebral body extending into the bilateral transverse foramen (Fig. 2A). 18F-Fluorodeoxyglucose (fludeoxyglucose F 18) positron emission tomography (FDG-PET)/CT showed significant uptake at the C5 vertebral body (Fig. 3A).
Axial CT during denosumab treatment.. Axial CT of the C5 vertebra. A. Before denosumab treatment; B, 6 months; C, 12 months; D, 24 months after treatment with denosumab. Gradual regression and surrounding osteosclerosis were noted on the lytic areas, which were seen before denosumab treatment.
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C5 vertebral body, whose posterior wall protruded into the spinal canal (Fig. 1). Computed tomography (CT) revealed an expansive osteolytic mass lesion on the C5 vertebral body extending into the bilateral transverse foramen (Fig. 2A). 18F-Fluorodeoxyglucose (fludeoxyglucose F 18) positron emission tomography (FDG-PET)/CT showed significant uptake at the C5 vertebral body (Fig. 3A). CT showed dramatic regression and surrounding sclerosis of the tumor six months after denosumab administration (Fig. 2B). During follow-up, gradual regression and surrounding osteosclerosis were noted on the previously lytic areas every 6 months for 2 years (Fig. 2A-D), without any adverse events.
Axial 18F-FDG PET/CT of the C5 vertebra.. A. Before denosumab treatment, an obviously lobulated FDG uptake was noted; B, 2 years after denosumab treatment, no uptake was seen.
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C5 vertebral body, whose posterior wall protruded into the spinal canal (Fig. 1). Computed tomography (CT) revealed an expansive osteolytic mass lesion on the C5 vertebral body extending into the bilateral transverse foramen (Fig. 2A). 18F-Fluorodeoxyglucose (fludeoxyglucose F 18) positron emission tomography (FDG-PET)/CT showed significant uptake at the C5 vertebral body (Fig. 3A). Following FDG-PET/CT showed no obvious uptake (Fig. 3B).
Histology of the biopsy specimen before denosumab treatment.. Numerous giant cells with a large vesicular nucleus exist, which is consistent with GCT. Scale bar = 100 mum.
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The tumor was osteolytic and friable, and diagnosed histologically as a GCT of the bone (Fig. 4).