Case 1 – Multidisciplinary treatment of a giant cell tumor of the bone affecting the sacrum of a young woman

Giant cell tumor (GCT) of the bone is a benign but locally aggressive tumor arising in the bones. The sacrum represents the most common involved site of the spine. At this level GCT might cause relevant neurological deficits and/or impair activities of daily living. The mainstay of treatment is still represented by the adequate removal of the tumor limiting at the same time the impact of surgery. However, GCT may relapse or present in “difficult” locations or with very large destructive lesions that may not be operated preserving the function of the involved bone. In this scenario, subcutaneous administration of denosumab, a fully-humanized monoclonal antibody specifically directed against RANK-L, can reduce surgical risks and invasiveness improving outcomes. Here we present the case of a young lady affected by a large GCT of the sacrum that emphasizes the importance of the multidisciplinary management of this disease taking into account patient’s preferences.