phenylephrine-hydrochloride and Giant-Cell-Tumors

Giant cell tumors (GCTs) are histologically benign bone neoplasms with a locally aggressive nature that primarily occur in the epiphyses of the long bones. A small proportion of these tumors, however, occur in the pelvis, spine, or skull bones. Among these, GCTs of the skull base cannot be completely resected and require adjuvant therapy. We report a juvenile case of clival GCT that was successfully treated by endoscopic endonasal transsphenoidal surgery and subsequent adjuvant therapy with denosumab, a monoclonal antibody to receptor activator of nuclear factor-κB ligand.. A 16-year-old boy was admitted to our hospital with progressively intolerable headache and right oculomotor nerve palsy. Computed tomography and magnetic resonance imaging showed a large tumor mass in the sphenoid sinus with extensive erosion of the clivus and compression of the right cavernous sinus. The tumor was resected by endonasal transsphenoidal surgery and histologically diagnosed as GCT. The giant cells showed positive immunostaining for CD68 and Mib-1 labeling index was less than 1.0%. Postoperative course was uneventful and the oculomotor disturbance was markedly improved. However, magnetic resonance imaging 2 weeks after surgery revealed marked enlargement of the tumor. Adjuvant therapy with denosumab was therefore initiated, resulting in marked reductions in tumor size.. This is the first report to describe beneficial effects of denosumab in the treatment of GCT of the skull base.

Topics: Adolescent; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Bone Density Conservation Agents; Cranial Fossa, Posterior; Denosumab; Endoscopy; Fluorodeoxyglucose F18; Giant Cell Tumors; Humans; Ki-67 Antigen; Magnetic Resonance Imaging; Male; Nose; Positron-Emission Tomography; Skull Base Neoplasms; Sphenoid Bone; Tomography, X-Ray Computed

Giant cell tumors (GCTs) are extremely rare lesions, representing less than 5% of all bone tumors. They primarily occur in the long bones. However, a small percentage of these tumors occur in the pelvis, spine, or skull bones. These lesions are usually benign as well as locally aggressive and require complete removal. Nowadays, GCT and other skull base lesions can be treated using the extended endoscopic endonasal approach. We present a case report of a GCT located in the skull base, originating from the clivus and sphenoid bone, invading through the cavernous sinus, and treated using the fully endoscopic endonasal approach.

Topics: Adult; Cavernous Sinus; Cranial Fossa, Posterior; Female; Giant Cell Tumors; Humans; Natural Orifice Endoscopic Surgery; Neoplasm Invasiveness; Neurosurgical Procedures; Nose; Skull Base Neoplasms; Sphenoid Bone; Temporal Lobe

Topics: Adolescent; Adult; Child; Child, Preschool; Ethmoid Sinus; Female; Fibroma; Frontal Sinus; Giant Cell Tumors; Humans; Male; Maxillary Sinus; Middle Aged; Nasopharyngeal Neoplasms; Nasopharynx; Neoplasm Recurrence, Local; Neoplasms, Connective Tissue; Nose; Nose Neoplasms; Ossification, Heterotopic; Osteoma; Osteoma, Osteoid; Osteosarcoma; Paranasal Sinus Neoplasms; Paranasal Sinuses; Sphenoid Sinus

Topics: Aged; Bone Neoplasms; Female; Giant Cell Tumors; Humans; Nose; Nose Neoplasms

Topics: Giant Cell Tumors; Humans; Nose; Nose Neoplasms

Topics: Giant Cell Tumors; Humans; Nose; Nose Neoplasms