Giant Cells Tumour

Background: The first line of treatment of Giant Cells Tumor (GCT) consists in thecurettage and coverage with bone graft. New treatments as Denosumab have showngreat results as adjuvants in its treatment, and is gaining popularity in thetreatment, especially because the high rates of local recurrence after surgery and thelimitations of the technique in very aggressive tumors, or in those located incomplex regions. This monoclonal antibody inhibits Receptor Activator of NuclearFactor Kappa Beta Ligand (RANKL) and can only be administered in skeletallymature patients, so it is contraindicated during pregnancy. There are other adjuvanttherapies to surgery, such as cryotherapy with liquid nitrogen or the phenolization,which can be equally effective.Methods: We present the case of a pregnant woman of 28 years old diagnosed with anaggressive GCT of proximal tibia during the first trimester of pregnancy. On thisoccasion, surgical treatment was performed by curettage and high speed milling.Adjuvant treatment was added with liquid nitrogen and the cavity was filled in withdemineralized bone matrix and hydroxyapatite. Based on our experience and on arevision of the literature, there are few cases described of the treatment of a GCT in awoman during the pregnancy.Results: The patient's symptoms disappeared after the intervention. There have notbeen shown signs of recurrence after 10 months of clinical follow-up and simpleradiology controls. The treatment did not produce adverse effects in the fetus duringpregnancy neither breastfeeding.Conclusions: Indications of Denosumab in the treatment of GCT include unresectabletumors or those in which its resection leads to high morbidity, as well as tumors in thespine, sacrum, pelvis and challenging lesions located in the upper and lower extremities.If we cannot opt for this drug for medical or other reasons, cryotherapy with liquidnitrogen may be effective in its treatment