Denosumab: a potential treatment option for aneurysmal bone cyst of the atlas

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
Ravish Shammi PatelNaresh Kumar

Abstract

Aneurysmal bone cysts (ABCs) of spine are conventionally treated with en-bloc resection or intralesional excision/curettage and reconstruction or filling of defects with bone cement. For the treatment of upper cervical ABCs, en-bloc resections are often not desirable considering the risk/benefit ratio while the risk of recurrence after intralesional excision is high. Hence, alternative management options are often necessary. We describe our clinical experience with one such treatment alternative-denosumab for the treatment of ABC of Atlas. We present a case of 16-year-old boy who presented with neck pain and restriction of neck movements. A large lytic lesion with multiple fluid-fluid interfaces involving vertebral arch of atlas was identified on further imaging. There was destruction of right lateral mass and the lesion was found encasing the right vertebral artery. Core needle biopsy confirmed the diagnosis of ABC. With no visible CT response after first session of intra-lesional injection of Calcitonin and Methylprednisolone, the patient was treated with denosumab (120 mg SC once-a-month) for a period of 12 months. His symptoms resolved within 7 months of onset of treatment and serial CT scans over 12-month treatment period ...Continue Reading

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Citations

Nov 27, 2018·Head & Neck·Karim W AsiEhab Y Hanna
Mar 8, 2019·Current Opinion in Oncology·Astrid LipplaaHans Gelderblom
Nov 10, 2018·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Runqi WangqinZeguang Ren
Oct 22, 2019·BMC Musculoskeletal Disorders·Hans Roland DürrAlexander Klein
Apr 25, 2018·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Stefano Boriani
Sep 6, 2021·Joint, Bone, Spine : Revue Du Rhumatisme·Julien MaximenPascal Guggenbuhl

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