Aneurysmal bone cyst and osteoblastoma after neoadjuvant denosumab: histologic spectrum and potential diagnostic pitfalls
Yin P. Hung
Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
Search for more papers by this authorMiriam A. Bredella
Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
Search for more papers by this authorIngvild V. K. Lobmaier
Department of Pathology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway
Search for more papers by this authorSantiago A. Lozano-Calderón
Department of Orthopedics, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
Search for more papers by this authorAndrew E. Rosenberg
Department of Pathology and Laboratory Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
Search for more papers by this authorCorresponding Author
G. Petur Nielsen
Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
G. Petur Nielsen, Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA. e-mail: [email protected]
Search for more papers by this authorYin P. Hung
Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
Search for more papers by this authorMiriam A. Bredella
Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
Search for more papers by this authorIngvild V. K. Lobmaier
Department of Pathology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway
Search for more papers by this authorSantiago A. Lozano-Calderón
Department of Orthopedics, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
Search for more papers by this authorAndrew E. Rosenberg
Department of Pathology and Laboratory Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
Search for more papers by this authorCorresponding Author
G. Petur Nielsen
Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
G. Petur Nielsen, Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA. e-mail: [email protected]
Search for more papers by this authorAbstract
The use of denosumab to treat giant cell tumors of bone (GCT) and other giant cell-containing bone tumors has become more common. While the clinicopathologic features of denosumab-treated giant cell tumors of bone have been well-illustrated, descriptions of other denosumab-treated bone tumors are very limited. Surgical pathology files of two institutions and consultation files from two authors were searched for denosumab-treated aneurysmal bone cysts and denosumab-treated osteoblastomas. Clinicopathologic features were reviewed and analyzed. We identified four patients with denosumab-treated bone tumors other than GCT from our surgical pathology and consultation files, including two aneurysmal bone cysts and two osteoblastomas. All were treated with denosumab for 0.5-7.0 (median 4.5) months. Radiologically, denosumab-treated tumors showed decreased size with increased ossification and mineralization on CT and heterogeneous intermediate to hypointense signal on MRI. Histologically, denosumab-treated aneurysmal bone cyst contained thin, elongated, curvilinear, and anastomosing strands of bone with empty lacunae, while denosumab-treated osteoblastoma showed circumscribed nodules of woven bone lined by small osteoblasts. Denosumab-treated aneurysmal bone cyst and osteoblastoma showed treatment-related morphologic changes that can mimic other bone neoplasms. Their recognition requires correlation with the clinical history of denosumab use and radiologic findings.
CONFLICT OF INTEREST
YPH, AER, and GPN received royalties from Elsevier for authoring pathology book chapters, which are unrelated to this study.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author upon reasonable request.
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