Dramatic Response to Denosumab in a Locally Advanced Osteoblastoma of the C5-C6 Vertebrae. A Case Report

Machak GN*, Snetkov AI and Romanova TN

Federal State Budgetary Institution, “National Medical Research Center for Traumatology and Orthopedics named after N.N. Priorov” of the Ministry of Health of the Russian Federation, Russia

^*Correspondance to: Gennady Machak 

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Abstract:

Osteoblastoma is a rare (1% of all primary bone tumors), benign, locally aggressive bone-forming tumor, commonly observed in the second and third decades of life. There are no established pharmacological options for patients in whom resection is not feasible. Novel pathogenetic therapies are currently being investigated in primary osteolytic bone tumors. We report a case of locally advanced osteoblastoma of the C5-C6 vertebrae treated with denosumab. The tumor response was dramatic and consisted of rapid pain relief, increased cervical spine stability, and significant tumor calcification on CT scan. PET/CT showed a complete metabolic response. Our findings demonstrate the possible involvement of the RANKL-RANK axis in the pathogenesis of osteoblastoma. It has been hypothesized that RANKL inhibition disrupts the vicious cycle at the osteoblastoma microenvironment, leading to tumor ossification and demarcation. Emerging pathogenetic therapy of osteoblastomas can have a significant clinical impact in locally advanced and inoperable cases as neoadjuvant or definitive treatment. Additional experimental and clinical studies are required to confirm the viability of this concept.

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Cite the Article:

Machak GN, Snetkov AI, Romanova TN. Dramatic Response to Denosumab in a Locally Advanced Osteoblastoma of the C5-C6 Vertebrae. A Case Report. Ann Clin Case Rep. 2024; 9: 2559..