Inoperable Sacral Giant Cell Tumor: Therapeutic Options and Pain Control^[*]

Abstract

Sacral giant cell tumor (GCT) is a rare condition. Its treatment is complex, since surgical removal is difficult and the response to other therapeutic options is low. The control of its growth and pain is an additional challenge. The present paper reports a case of inoperable sacral GCT, with embolization and radiotherapy for pain control as therapeutic options. The patient, a 39-year-old male, presented pain in the sacral region with lower limb irradiation due to an inoperable sacral giant cell tumor. The patient was submitted to embolization, radiotherapy, pain management with opioids and other drugs, and a rehabilitation program. Despite the difficulty in tumor growth and pain control during the follow-up, the outcome is stable after 9 years.

Keywords

giant cell tumors - orthopedics - chronic pain

^* Work performed at Rede Sarah de Hospitais de Reabilitação, Brasília, DF, Brazil, and presented at the Instituto de Ensino e Pesquisa from the Hospital Sírio Libanês to obtain the certification as a specialist in the care of patients with pain.

• Referências

• 1 Camargo OP, Croci AT, Oliveira CR, Baptista AM, Caiero MT, Giannotti MA. Tumor de células gigantes: evolução histórica do seu diagnóstico e tratamento junto ao Instituto de Ortopedia e Traumatologia da FMUSP. Acta Ortop Bras 2001; 9 (04) 46-52
• 2 Catalan J, Fonte AC, Lusa JRB, Oliveira AD, Melo ES, Justino Júnior RO. , et al. Tumor de células gigantes ósseo: aspectos clínicos e radiográficos de 115 casos. Radiol Bras, São Paulo 2006; 39 (02) 119-122
• 3 Ciftdemir M, Kaya M, Selcuk E, Yalniz E. Tumors of the spine. World J Orthop 2016; 7 (02) 109-116
• 4 King T, Porreca F. Opioids in cancer pain: new considerations. Pain Clin Updates IASP. 2010; 18 (01) 1-5
• 5 Yasko AW. Interferon therapy for giant cell tumor of bone. Curr Opin Orthop 2006; 17: 568-572
• 6 Formenti SC, Demaria S. Systemic effects of local radiotherapy. Lancet Oncol 2009; 10 (07) 718-726
• 7 Branstetter DG, Nelson SD, Manivel JC, Blay JY, Chawla S, Thomas DM. , et al. Denosumab induces tumor reduction and bone formation in patients with giant-cell tumor of bone. Clin Cancer Res 2012; 18 (16) 4415-4424
• 8 Ferreira KAS, Kimura M, Teixeira MJ, Nobrega JC. Preditores de controle inadequado da dor entre pacientes com dor oncológica. In: 7° Congresso Brasileiro de Dor, Gramado, RS; 2006
• 9 Junming M, Cheng Y, Dong C, Jianru X, Xinghai Y, Quan H. , et al. Giant cell tumor of the cervical spine: a series of 22 cases and outcomes. Spine 2008; 33 (03) 280-288