Chemotherapy,denosumab combined with 3D printed prosthesis in the treatment of metacarpal giant cell tumor with lung metastasis:a case report
ZHAI Kai
YU Xiu-chun
BAO Zhe-ming
XU Ming
Abstract：Objective To study the feasibility and early clinical efficacy of chemotherapy,denosumab combined with 3D printed prosthesis to treat giant cell tumor of metacarpal bone with multiple lung metastases.Methods A retrospective analysis of a 25-year-old female patient admitted to our hospital due to the discovery of a growing mass on the back of her left hand more than 2 years ago was made.Based on the imaging data and pathological results,she was diagnosed as giant cell tumor of the third metacarpal bone of the left hand with multiple lung metastases.Before surgery,2 courses of DIA regimen chemotherapy combined with 4 treatment of denosumab were given.With the assistance of 3D printing,the prosthesis was designed with a porous structure on the contact surface between the proximal end and the capitate bone and a smooth metal surface on the distal metacarpal head.After excluding surgical contraindications,the left third metacarpal bone resection+3D printing metal prosthesis replacement was performed under general anesthesia.The joint function was followed up after surgery.The position of the prosthesis and internal fixation were observed through X-rays.Complications were recorded,and pulmonary metastases were observed through chest CT.Relevant literature was reviewed and relevant treatment strategies for giant cell tumor of the metacarpal bone were discussed.Results After chemotherapy and denosumab treatment,an obvious sclerosis zone appeared at the edge of the tumor,and the volume was smaller than before.During the operation,the tumor was completely resected along the safe margin.The capitate osteotomy and the installation of metacarpal prosthesis were completed according to the preoperative design.After surgery,denosumab treatment was continued,and the follow-up time was 17 months.There was no tumor recurrence,infection,prosthesis loosening or other complications.At the last follow-up,the flexion of the middle finger was slightly limited and the size of the largest lung metastasis was reduced.No new metastasis was found.Conclusions After chemotherapy and denosumab application,a clearer tumor boundary is obtained.Metacarpal prosthesis designed with the assistance of 3D printing repairs the bone defect,and the early clinical efficacy is satisfactory.
Keywords：Giant cell tumor of boneMetacarpal bonesChemoradiotherapyadjuvantPrintingthree-dimensionalDenosumab
Publication Date：2024-11-19
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 916-923 )