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Updated: Mar 29, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Giant cell tumor of the humeral head treated by denosumab: Implication to shoulder surgeons
Ka Hei Leung1, Albert Ying Lee Lam1, Kenneth Wai Yip Ho1
1Department of Orthopaedics and Traumatology, Division of Anatomical Pathology, Queen Mary Hospital, Hong Kong.
Abstract:
Giant cell tumor is a benign bone tumor that is commonly encountered. The optimal treatment of a giant cell tumor which causes extensive bony destruction is controversial. Recent studies on the receptor activator of nuclear factor κB ligand antagonist denosumab may offer a new treatment option for these patients. We presented a patient with giant cell tumor of the humeral head. He was initially treated with denosumab and subsequently with the operation. The shoulder joint was successfully salvaged. But there are potential difficulties that surgeons may face in patients treated with denosumab.
Insights
Giant cell tumors can cause significant bone destruction. Treatment with denosumab, a receptor activator of nuclear factor κB ligand antagonist, followed by surgery, successfully salvaged a humeral head tumor, though surgical challenges exist.
Area of Science:
- Orthopedics
- Oncology
- Pharmacology
Background:
- Giant cell tumor (GCT) is a common benign bone neoplasm.
- Extensive bony destruction by GCT presents complex treatment challenges.
- Receptor activator of nuclear factor κB ligand (RANKL) inhibitors are emerging as a therapeutic option.
Observation:
- A case of GCT in the humeral head causing extensive bony destruction is presented.
- The patient was initially treated with denosumab, a RANKL inhibitor.
- Subsequent surgical intervention was performed after denosumab treatment.
Findings:
- The combined treatment approach successfully salvaged the shoulder joint.
- Denosumab treatment prior to surgery may alter tumor characteristics.
- Potential surgical difficulties were encountered in the post-denosumab treatment setting.
Implications:
- Denosumab offers a potential neoadjuvant treatment for GCT, facilitating joint salvage.
- Surgeons must be aware of potential intraoperative challenges when operating on denosumab-treated GCT.
- Further research is warranted to optimize surgical techniques for GCT patients treated with RANKL inhibitors.
