Giant cell tumor of bone (GCTB) is a rare, benign, but locally aggressive bone
tumor. It has a high tendency for local recurrence, which may increase the incidence of lung
metastasis. Currently, an optimal treatment strategy has not been established because of the rarity of pulmonary metastatic GCTB.
Denosumab is the preferred regimen for unresectable metastatic lesions; however, there are no alternative treatment options when patients are resistant to
denosumab.
Apatinib is a small-molecule
tyrosine kinase inhibitor that selectively competes for the
vascular endothelial growth factor receptor 2 (VEGFR-2)
ATP binding site, and several studies have analyzed the effectiveness of
apatinib in advanced or metastatic
tumors. However, there is no report of
apatinib as an anti-angiogenesis
therapy for pulmonary metastatic GCTB to date. Here, we present a case of a 26-year-old female who was diagnosed with recurrent and pulmonary metastatic GCTB. Immunohistochemical (IHC) staining indicated that the
tumor cells were positive for
VEGFR-2.
Denosumab was administered to control the
metastases; nevertheless,
disease progression was confirmed after four months of treatment. Given the IHC results and rapid
disease progression,
apatinib was added to the treatment strategy. After 42 months of treatment, the patient showed noticeable symptomatic improvement and considerable
tumor shrinkage.