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Giant cell tumor of bone

Key sources
The following summarized guidelines for the evaluation and management of giant cell tumor of bone are prepared by our editorial team based on guidelines from the European Reference Network on Genetic Tumour Risk Syndromes (GENTURIS/ERN PaedCan/EURACAN/ESMO 2021) and the National Comprehensive Cancer Network (NCCN 2021).
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Guidelines

1.Diagnostic investigations

History and physical examination: as per ESMO 2021 guidelines, elicit medical history and perform physical examination in the initial work-up of patients with suspected primary bone sarcoma.
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  • Imaging for staging

2.Diagnostic procedures

Biopsy and histopathology: as per ESMO 2021 guidelines, perform biopsy in the initial work-op of patients with suspected primary bone sarcoma.
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3.Medical management

Setting of care: as per ESMO 2021 guidelines, manage patients with bone sarcomas at reference centers and/or within reference networks able to provide access to the full spectrum of care and age-specific expertise.
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  • Denosumab

  • Interferon alpha-2b

4.Therapeutic procedures

Serial arterial embolization: perform serial arterial embolization as a preferred treatment option in patients with localized disease, if resectable with unacceptable morbidity or with unresectable axial lesions.
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  • Radiotherapy

5.Surgical interventions

Surgical excision: as per ESMO 2021 guidelines, perform en bloc excision
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or intralesional curettage with or without adjuvant therapy in selected patients with GCTB.
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6.Specific circumstances

Patients with malignant transformation: manage patients with malignant transformation as patients with osteosarcoma.
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7.Follow-up and surveillance

Assessment of treatment response: obtain follow-up imaging, plain radiographs and CT with or without MRI (both with contrast), to assess treatment response.
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  • Surveillance

  • Management of recurrent disease