PMC7530181_01
Radiography before and after denosumab in four children with Noonan-like/multiple giant cell lesions (NL/MGCLs). (A-H) Case 1 baseline images (A-D) of 3-dimensional (3D) computed tomography (CT) reconstruction of frontal (A) and profile (B) views, axial CT without contrast (C), and axial magnetic resonance imaging (MRI) (D) at the level of mandibular molars relative to post-denosumab (E-H) 3D CT reconstruction of frontal (E) and profile (F) views, axial CT without contrast (G) 8 months after initial denosumab treatment, and axial magnetic resonance imaging (MRI) (F) at the level of mandibular molars 15 months after second denosumab treatment. (I-L) Case 2 dental orthopantomogram at baseline (I) and after on denosumab for 6 (J), 12 (K), and 18 (L) months. (M, N) Case 3: dental orthopantomogram at baseline (M) and after on denosumab for 5 months (N). (O,P) Case 4: baseline axial (O) and coronal (P) CT without contrast at level of mandibular molars. Red arrows and circles denote NL/MGCLs.
fped-08-00515-g0001.jpg
PMC7530181_05_fped-08-00515-g0001.jpg
F1
CT scan revealed bilateral mandibular, expansile cysts with cortical thinning (Figure 1). Knee and bone age X-rays performed throughout treatment were remarkable for dense sclerotic metaphyseal bands and widening of the growth plates (Supplemental Figure 1).
Laboratory assessment in relation to denosumab pre-treatment, during treatment, and post-treatment in four children with Noonan-like/multiple giant cell lesions (NL/MGCLs). (A) Serum calcium. (B) Serum phosphorus. (C) Parathyroid hormone (PTH). (D) Alkaline Phosphatase. (E) Serum carboxy-terminal telopeptide (C-Telopeptide), marker of bone resorption. (F) Osteocalcin, marker of bone formation. Normal ranges for calcium and phosphorus are indicated by dashed line.
fped-08-00515-g0002.jpg
PMC7530181_05_fped-08-00515-g0002.jpg
F2
Calcium levels were slightly low (8.4 mg/dL); therefore, he was advised to take calcium and vitamin D3 supplements (Figure 2).
PMC7530181_02
Radiography before and after denosumab in four children with Noonan-like/multiple giant cell lesions (NL/MGCLs). (A-H) Case 1 baseline images (A-D) of 3-dimensional (3D) computed tomography (CT) reconstruction of frontal (A) and profile (B) views, axial CT without contrast (C), and axial magnetic resonance imaging (MRI) (D) at the level of mandibular molars relative to post-denosumab (E-H) 3D CT reconstruction of frontal (E) and profile (F) views, axial CT without contrast (G) 8 months after initial denosumab treatment, and axial magnetic resonance imaging (MRI) (F) at the level of mandibular molars 15 months after second denosumab treatment. (I-L) Case 2 dental orthopantomogram at baseline (I) and after on denosumab for 6 (J), 12 (K), and 18 (L) months. (M, N) Case 3: dental orthopantomogram at baseline (M) and after on denosumab for 5 months (N). (O,P) Case 4: baseline axial (O) and coronal (P) CT without contrast at level of mandibular molars. Red arrows and circles denote NL/MGCLs.
fped-08-00515-g0001.jpg
PMC7530181_05_fped-08-00515-g0001.jpg
F1
CT scan revealed bilateral mandibular, expansile cysts with cortical thinning (Figure 1). Knee and bone age X-rays performed throughout treatment were remarkable for dense sclerotic metaphyseal bands and widening of the growth plates (Supplemental Figure 1).
Laboratory assessment in relation to denosumab pre-treatment, during treatment, and post-treatment in four children with Noonan-like/multiple giant cell lesions (NL/MGCLs). (A) Serum calcium. (B) Serum phosphorus. (C) Parathyroid hormone (PTH). (D) Alkaline Phosphatase. (E) Serum carboxy-terminal telopeptide (C-Telopeptide), marker of bone resorption. (F) Osteocalcin, marker of bone formation. Normal ranges for calcium and phosphorus are indicated by dashed line.
fped-08-00515-g0002.jpg
PMC7530181_05_fped-08-00515-g0002.jpg
F2
Calcium levels were slightly low (8.4 mg/dL); therefore, he was advised to take calcium and vitamin D3 supplements (Figure 2).
PMC7530181_03
Radiography before and after denosumab in four children with Noonan-like/multiple giant cell lesions (NL/MGCLs). (A-H) Case 1 baseline images (A-D) of 3-dimensional (3D) computed tomography (CT) reconstruction of frontal (A) and profile (B) views, axial CT without contrast (C), and axial magnetic resonance imaging (MRI) (D) at the level of mandibular molars relative to post-denosumab (E-H) 3D CT reconstruction of frontal (E) and profile (F) views, axial CT without contrast (G) 8 months after initial denosumab treatment, and axial magnetic resonance imaging (MRI) (F) at the level of mandibular molars 15 months after second denosumab treatment. (I-L) Case 2 dental orthopantomogram at baseline (I) and after on denosumab for 6 (J), 12 (K), and 18 (L) months. (M, N) Case 3: dental orthopantomogram at baseline (M) and after on denosumab for 5 months (N). (O,P) Case 4: baseline axial (O) and coronal (P) CT without contrast at level of mandibular molars. Red arrows and circles denote NL/MGCLs.
fped-08-00515-g0001.jpg
PMC7530181_05_fped-08-00515-g0001.jpg
F1
CT scan revealed bilateral mandibular, expansile cysts with cortical thinning (Figure 1). Knee and bone age X-rays performed throughout treatment were remarkable for dense sclerotic metaphyseal bands and widening of the growth plates (Supplemental Figure 1).
Laboratory assessment in relation to denosumab pre-treatment, during treatment, and post-treatment in four children with Noonan-like/multiple giant cell lesions (NL/MGCLs). (A) Serum calcium. (B) Serum phosphorus. (C) Parathyroid hormone (PTH). (D) Alkaline Phosphatase. (E) Serum carboxy-terminal telopeptide (C-Telopeptide), marker of bone resorption. (F) Osteocalcin, marker of bone formation. Normal ranges for calcium and phosphorus are indicated by dashed line.
fped-08-00515-g0002.jpg
PMC7530181_05_fped-08-00515-g0002.jpg
F2
Calcium levels were slightly low (8.4 mg/dL); therefore, he was advised to take calcium and vitamin D3 supplements (Figure 2).
PMC7530181_04
Radiography before and after denosumab in four children with Noonan-like/multiple giant cell lesions (NL/MGCLs). (A-H) Case 1 baseline images (A-D) of 3-dimensional (3D) computed tomography (CT) reconstruction of frontal (A) and profile (B) views, axial CT without contrast (C), and axial magnetic resonance imaging (MRI) (D) at the level of mandibular molars relative to post-denosumab (E-H) 3D CT reconstruction of frontal (E) and profile (F) views, axial CT without contrast (G) 8 months after initial denosumab treatment, and axial magnetic resonance imaging (MRI) (F) at the level of mandibular molars 15 months after second denosumab treatment. (I-L) Case 2 dental orthopantomogram at baseline (I) and after on denosumab for 6 (J), 12 (K), and 18 (L) months. (M, N) Case 3: dental orthopantomogram at baseline (M) and after on denosumab for 5 months (N). (O,P) Case 4: baseline axial (O) and coronal (P) CT without contrast at level of mandibular molars. Red arrows and circles denote NL/MGCLs.
fped-08-00515-g0001.jpg
PMC7530181_05_fped-08-00515-g0001.jpg
F1
CT scan revealed bilateral mandibular, expansile cysts with cortical thinning (Figure 1). Knee and bone age X-rays performed throughout treatment were remarkable for dense sclerotic metaphyseal bands and widening of the growth plates (Supplemental Figure 1).
Laboratory assessment in relation to denosumab pre-treatment, during treatment, and post-treatment in four children with Noonan-like/multiple giant cell lesions (NL/MGCLs). (A) Serum calcium. (B) Serum phosphorus. (C) Parathyroid hormone (PTH). (D) Alkaline Phosphatase. (E) Serum carboxy-terminal telopeptide (C-Telopeptide), marker of bone resorption. (F) Osteocalcin, marker of bone formation. Normal ranges for calcium and phosphorus are indicated by dashed line.
fped-08-00515-g0002.jpg
PMC7530181_05_fped-08-00515-g0002.jpg
F2
Calcium levels were slightly low (8.4 mg/dL); therefore, he was advised to take calcium and vitamin D3 supplements (Figure 2).
PMC7530181_05
Radiography before and after denosumab in four children with Noonan-like/multiple giant cell lesions (NL/MGCLs). (A-H) Case 1 baseline images (A-D) of 3-dimensional (3D) computed tomography (CT) reconstruction of frontal (A) and profile (B) views, axial CT without contrast (C), and axial magnetic resonance imaging (MRI) (D) at the level of mandibular molars relative to post-denosumab (E-H) 3D CT reconstruction of frontal (E) and profile (F) views, axial CT without contrast (G) 8 months after initial denosumab treatment, and axial magnetic resonance imaging (MRI) (F) at the level of mandibular molars 15 months after second denosumab treatment. (I-L) Case 2 dental orthopantomogram at baseline (I) and after on denosumab for 6 (J), 12 (K), and 18 (L) months. (M, N) Case 3: dental orthopantomogram at baseline (M) and after on denosumab for 5 months (N). (O,P) Case 4: baseline axial (O) and coronal (P) CT without contrast at level of mandibular molars. Red arrows and circles denote NL/MGCLs.
fped-08-00515-g0001.jpg
PMC7530181_05_fped-08-00515-g0001.jpg
F1
CT scan revealed bilateral mandibular, expansile cysts with cortical thinning (Figure 1). Knee and bone age X-rays performed throughout treatment were remarkable for dense sclerotic metaphyseal bands and widening of the growth plates (Supplemental Figure 1).
Laboratory assessment in relation to denosumab pre-treatment, during treatment, and post-treatment in four children with Noonan-like/multiple giant cell lesions (NL/MGCLs). (A) Serum calcium. (B) Serum phosphorus. (C) Parathyroid hormone (PTH). (D) Alkaline Phosphatase. (E) Serum carboxy-terminal telopeptide (C-Telopeptide), marker of bone resorption. (F) Osteocalcin, marker of bone formation. Normal ranges for calcium and phosphorus are indicated by dashed line.
fped-08-00515-g0002.jpg
PMC7530181_05_fped-08-00515-g0002.jpg
F2
Calcium levels were slightly low (8.4 mg/dL); therefore, he was advised to take calcium and vitamin D3 supplements (Figure 2).