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Interferon Alfa-2b for Recurrent and Metastatic Giant Cell Tumor of the Spine: Report of Two Cases

Wei, Feng, MD; Liu, Xiaoguang, MD; Liu, Zhongjun, MD; Jiang, Liang, MD; Dang, Gengting, MD; Ma, Qingjun, MD; Dang, Lei, MD

doi: 10.1097/BRS.0b013e3181e7bf5a
Case Reports
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Study Design. Case report.

Objective. To demonstrate that interferon alfa-2b is a therapeutic option for obtaining long-term control of recurrent and metastatic giant cell tumor of spine.

Summary of Background Data. Interferon alfa served as angiogenesis inhibitor and has been successfully used to treat giant cell tumor of long bones and facial bones. Up to date, no report is found with regard to the use of interferon as a stand-alone treatment for unresectable, recurrent, and metastatic giant cell tumor originated from the spine.

Methods. A 29-year-old woman with C1 and C2 giant cell tumor was treated by radiotherapy, intralesional curet, and chemotherapy orderly. Tumor recurred after 2 years. A second curet was undertaken. Tumor recurred second time and caused severe spinal cord compression. Lung metastasis was diagnosed simultaneously. A 24-year-old man with recurrent giant cell tumor of T5 and T6 was treated by spondylectomy of T5 and T6. Six months later, a giant metastatic lesion was found in sacrococcygeal region, which was excised and proved to be giant cell tumor of bone. Four months later, 2 recurrent lesions were found beside the rectum. Interferon alfa-2b at a dose of 3,000,000 U/m2 was then administered subcutaneously everyday for both patients for 3.5 and 3 years, respectively.

Results. No major complications related to the use of interferon occurred. The lesion in C1-C2 of the first patient regressed steadily and was restricted and encircled within the lateral mass. The metastatic lesions in the lungs also significantly reduced. The pararectal lesions of the second patient disappeared completely.

Conclusion. Interferon therapy may be an effective and safe treatment for spine giant cell tumor recurrence and metastasis in soft tissue. The effectiveness may be time and dosage dependent.

Recurrent and metastatic giant cell tumor of spine challenges the revision surgery and adjuvant treatment. Interferon alfa-2b may be an effective and safe therapeutic option for obtaining long-term control of unresectable, recurrent, and metastatic giant cell tumor of spine. These effects are time and dose dependent.

From the Department of Orthopedics, Peking University Third Hospital, Beijing, China.

Acknowledgment date: August 20, 2009. First revision date: November 14, 2009. Second revision date: March 14, 2010. Acceptance date: May 4, 2010.

The device(s)/drug(s) is/are FDA-approved or approved by corresponding national agency for this indication.

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

The study was approved by the Ethics Committee of Peking University Health Center.

Address correspondence and reprint requests to Xiaoguang Liu, MD, Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, China; E-mail: xgliu@bjmu.edu.cn

© 2010 Lippincott Williams & Wilkins, Inc.