Treatment of Giant Cell Tumor of Bone of the Extremities at Campanacci Stage 3 with Large Extraosseous Lesions

Clinical Scenario

This protocol applies to giant cell tumor of bone (GCTB) arising in the extremities at Campanacci stage 3 — the most advanced stage, in which large extraosseous soft-tissue extension beyond the cortex is present. En bloc resection is the indicated surgical approach for this presentation.

Clinical Goal

A primary aim in the preoperative period is shrinkage of the extraosseous lesion component to optimise conditions before definitive surgery.

Treatment Approach (Overview)

Management in this setting involves a short course of preoperative neoadjuvant therapy before en bloc resection, followed by skeletal reconstruction of the affected site. The specific agents, their number, the reconstruction approach, and any site-specific surgical considerations are detailed in the full structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

EBR is indicated for GCTB with large extraosseous lesions at Campanacci stage 3.

It has been reported that extraosseous lesions shrink with denosumab administration.

The administration of denosumab prior to EBR of Campanacci stage 3 GCTB may be recommended because it stiffens the tumor and reduces tumor spillover.

GCTB that frequently occurs at the epiphysis requires reconstruction with a megaprosthesis, allograft, or allograft prosthesis composite (APC) after EBR.

DOI: 10.3390/curroncol31040157

View source ↗