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Guest Editorial – Asia Pacific Musculoskeletal Tumor Society Conference 2018

July 10, 2018

Vol 4 | Issue 2 | July-Dec 2018 | page: 2-3 | Ajay Puri. Author: Ajay Puri [1]. [1] Orthopedic Oncology Services, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai. Address of Correspondence Dr. Ajay Puri, Department of Orthopaedic Oncology, Room No: 26, Tata Memorial Hospital, Borges Road, Parel, Mumbai – 400 012. India. Email: […]

Denosumab Therapy Related Changes in Giant cell Tumor (Osteoclastoma) of Bone : A New Osteosarcoma Mimicker

July 10, 2018

Vol 4 | Issue 2 | July-Dec 2018 | Page 4-6 | Pradnya Manglekar, Sujit Joshi, Yogesh Panchwagh. Authors: Pradnya Manglekar [1], Sujit Joshi [1], Yogesh Panchwagh [1]. [1] Dept. of Pathology Deenanath Mangeshkar Hospital and Research Centre, Pune [2] Orthopaedic Oncology Clinic, Pune, India. Address of Correspondence Dr. Sujit Joshi, Dept. of Pathology Deenanath […]

Guest Editorial – Asia Pacific Musculoskeletal Tumor Society Conference 2018

July 10, 2018

Denosumab Therapy Related Changes in Giant cell Tumor (Osteoclastoma) of Bone : A New Osteosarcoma Mimicker

July 10, 2018

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Guest Editorial – Asia Pacific Musculoskeletal Tumor Society Conference 2018

July 10, 2018

Vol 4 | Issue 2 | July-Dec 2018 | page: 2-3 | Ajay Puri.

Author: Ajay Puri [1].

[1] Orthopedic Oncology Services, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai.

Address of Correspondence
Dr. Ajay Puri,
Department of Orthopaedic Oncology, Room No: 26, Tata Memorial Hospital, Borges Road, Parel, Mumbai – 400 012. India.
Email: docpuri@gmail.com

Asia Pacific Musculoskeletal Tumor Society Conference 2018

For advances in musculo skeletal oncology to occur we need a host of clinical specialties along with nursing, rehabilitation and support staff interacting on a continuous basis. Sarcomas are rare and each individual and institution can only benefit from having access to pooled information and experience. For sarcoma care to evolve, ideas to surface and multi institute or multi-disciplinary collaborations to develop in the fields of basic research, patient care, biomaterials and prosthesis, there is a need for a common platform where all of us involved in the treatment of sarcomas can interact. Our socio economic milieu in the Asia Pacific region is unique. We have a spectrum ranging from resource rich societies with extensive state supported health care to resource constrained nations where patients have inconsistent access to health care and funding for health care is limited. Solutions and protocols applicable to the Western world need not necessarily be the most suitable in our scenario. Our large numbers coupled by the sheer native ingenuity necessary to offer quality health care in a resource challenged population can help us develop solutions that can be adapted everywhere.

The Asia Pacific Musculoskeletal Tumor Society (APMSTS) was conceptualized during discussions at the 7th International Symposium of Limb Salvage Surgeons (ISOLS) meeting in 1993 and its first meeting was held in 1995 in Japan under the stewardship of Professor Yoshio Ogihara. Mirroring a similar initiative, the Indian Musculo Skeletal Oncology Society (IMSOS) was established in 2013 to “promote scientific, evidence based, comprehensive multidisciplinary management of bone and soft tissue sarcomas and encourage basic and clinical research”. This year Jaipur, India plays host to the 12th APMSTS meeting in October. This is a joint meeting co-hosted with IMSOS. The theme of the conference is “Education – Collaboration – Innovation”. This epitomizes our desire to share and disseminate knowledge, the spirit of collaboration necessary to find answers to common problems and the need to derive innovative solutions best suited to our socio economic milieu.

The conference logo depicts the feathers of the peacock in the Indian national colours adorning a group of people with interlinked arms who represent the collaboration and camaraderie between individuals and countries that form the Asia Pacific Musculoskeletal Society. The logo represents the beauty and spirituality of India while signifying the desire to showcase skills from the Asia Pacific region. The peacock, the national bird of India symbolizes many of the qualities that we as “healers” must inculcate. In Hinduism, the peacock is associated with Saraswati the goddess of wisdom and learning. In Buddhism, the peacock is a symbol of purity and the ‘eyes’ in the peacock’s tail represent a symbol of watchfulness. The figure of the peacock is painted in various Islamic religious buildings while in Christianity the peacock was known as the symbol of resurrection and renewal. Just as the peacock elegantly unfolds its vibrant colours during its ritual dance, so too this conference is an occasion for us to demonstrate the best from all participating delegates.

We have more than 300 delegates from 28 countries participating in this meeting. Deviating from the accepted norm of didactic lectures the meeting focusses more on interactive sessions that will promote healthy discussion. There are case based panel discussions and sessions where senior musculoskeletal oncologists share their diverse experiences so that all attendees can benefit from the collective experience of others in order to enable them to make better decisions when managing similar cases. While providing adequate sessions for free papers there are two “show piece” orations. The IMSOS oration “Lessons learned from the European-American Osteosarcoma Study EURAMOS1” will be delivered by Prof. Stefan Bielack while the inaugural APMSTS “Prof. Yoshio Ogihara Oration” will be delivered by Dr. Suresh Nathan. The conference is preceded by multidisciplinary workshops that encompass all specialties involved in sarcoma care, offering delegates an opportunity to interact with faculty in smaller groups.

This unique joint meeting also offers the ideal platform to unveil a brief monograph “IMSOS guidelines for musculoskeletal sarcomas”, IMSOS’s endeavour to standardise the management of musculoskeletal sarcomas in India.

All our efforts are ultimately focussed on improving health care for our patients. A meeting such as this would be incomplete unless we involved them too. The IMSOS sarcoma support initiative will simultaneously conduct a parallel session that helps patients share their experience and presents an occasion where we can felicitate support personnel who selflessly give their time to enable us to optimise overall patient care.

We are sure the ambience and hospitality of Jaipur combined with an exciting and informative scientific programme will make this joint APMSTS – IMSOS conference a memorable and enriching event for all delegates.
It is our pleasure and privilege to welcome all attendees to Jaipur to partake of the experience that is “Incredible India”!

Prof. Ajay Puri
President – Indian Musculo Skeletal Oncology Society
President – Asia Pacific Musculoskeletal Tumor Society

How to Cite this article: Puri A. Asia Pacific Musculoskeletal Tumor Society 2018 Issue. Journal of Bone and Soft Tissue Tumors July-Dec 2018; 4(2):2-3.

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Denosumab Therapy Related Changes in Giant cell Tumor (Osteoclastoma) of Bone : A New Osteosarcoma Mimicker

July 10, 2018

Vol 4 | Issue 2 | July-Dec 2018 | Page 4-6 | Pradnya Manglekar, Sujit Joshi, Yogesh Panchwagh.

Authors: Pradnya Manglekar [1], Sujit Joshi [1], Yogesh Panchwagh [1].

[1] Dept. of Pathology Deenanath Mangeshkar Hospital and Research Centre, Pune
[2] Orthopaedic Oncology Clinic, Pune, India.

Address of Correspondence
Dr. Sujit Joshi,
Dept. of Pathology Deenanath Mangeshkar Hospital and Research Centre, Pune
Email: sujitjoshi30@gmail.com

Abstract

Objectives: Giant cell tumor (Osteoclastoma)of bone is locally aggressive osteolytic tumor. Denosumab–A monoclonal antibody against RANKL is recently being used to treat this tumor. We discuss histopathological changes occurring in giant cell tumor of bone after Denosumab treatment.
Method: A retrospective study of 12 cases from January 2014 to March 2018. All patients included were diagnosed as giant cell tumor (osteoclastoma) of bone on needle or open biopsy. Subsequently these patients received Denosumab therapy followed by surgical resection (extended curettage or wide excision). Histomorphological features after Denosumab therapy were evaluated in these specimens and compared with morphological features of prior biopsy samples.
Results: Needle or open biopsy samples studied prior to receiving Denosumab therapy showed typical morphological features of osteoclastoma i.e. presence of uniformly distributed osteoclastic cells and sheets of mononuclear stromal cells. No atypical mitoses or matrix production noted. Post Denosumab therapy resection specimens showed marked reduction in number of osteoclastic giant cells. There was predominance of mononuclear stromal cells along with abundant, irregular new bone (osteoid) formation with osteoid matrix deposition. Occasional mitotic activity was seen. Few foci of necrosis were noted.
Conclusion: Denosumab treatment causes significant giant cell depletion accompanied by abundant new bone formation separated by cellular stromal proliferation. These features bear very little resemblance to their pre-treatment counterparts and can mimic morphological features of osteosarcoma and other bone forming tumors. Hence, one should be aware of these changes so that a misdiagnosis of osteosarcoma can be avoided.
Keywords: Giant cell tumor (osteoclastoma), Denosumab, RANKL.

References

1. Kumar V, Abbas AK, Aster JC. Robbins and Cotran Pathologic Basis of Disease.9th edition. Saunders Elsevier: Philadelphia; 2015. Chapter 26, Bones, Joints and Soft tissue tumors; p1179 – 1226.
2. Rosai J. Rosai and Ackerman’s Surgical Pathology. 10thedition. Elsevier Mosby: St.Louis, Missouri; 2011. Chapter 24, Bone and joints; p2013-2104.
3. Branstetter DG, Nelson SD, Manivel JC, Blay JY et al. Denosumab induces Tumor Reduction and Bone formation in Patients with Giant-Cell Tumor of Bone. Clin Cancer Res; 18(16); 4415-24.2012 AACR.
4. Singh AS, Chawla NS, Chawla SP. Giant-cell tumor of bone: treatment options and role of denosumab. Biologics: Targets and Therapy 2015;9, 69-74.
5. Huang L, Teng XY, Cheng YY, Lee KM, Kumta SM. Expression of preosteoblast markers and Cbfa-1 and Osterix gene transcripts instromal tumour cells of giant cell tumour of bone. Bone 2004 Mar;34 (3):p393–401.
6. James IE, Dodds RA, Olivera DL, Nuttall ME, Gowen M. Human osteoclastoma-derived stromal cells: correlation of the ability to form mineralized nodules in vitro with formation of bone in vivo. J Bone Miner Res 1996 Oct;11 (10):1453–60.
7. Wojcik J, Rosenberg AE, Bredella MA, et al. Denosumab-treated giant cell tumor of bone exhibits morphologic overlap with malignant giant cell tumor of bone. Am J SurgPathol 2016 Jan; 40(1): 72-80.
8. Rekhi B, Verma V, Gulia A, et al. Clinicopathological features of a series of 27 cases of post-denosumab treated giant cell tumors ofbones: a single institutional experience at a tertiary cancer referralcentre, India. PatholOncol Res 2017 Jan; 23 (1): 157-64.
9. Chang-Che Wu, Pin-Pen Hsieh. Denosumab-Treated Giant Cell Tumor of the Bone Mimicking Low-Grade Central Osteosarcoma.Journal of Pathology and Translational Medicine 2018; 52: 133-135.

How to Cite this article: Manglekar P, Joshi S, Panchwagh Y. Denosumab Therapy Related Changes in Giant cell Tumor (Osteoclastoma) of Bone : A New Osteosarcoma Mimicker. Journal of Bone and Soft Tissue TumorsJuly-Dec 2018;4(2):4-6.

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Guest Editorial – Asia Pacific Musculoskeletal Tumor Society Conference 2018

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Denosumab Therapy Related Changes in Giant cell Tumor (Osteoclastoma) of Bone : A New Osteosarcoma Mimicker

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Guest Editorial – Asia Pacific Musculoskeletal Tumor Society Conference 2018

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Denosumab Therapy Related Changes in Giant cell Tumor (Osteoclastoma) of Bone : A New Osteosarcoma Mimicker

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Guest Editorial – Asia Pacific Musculoskeletal Tumor Society Conference 2018

Author: Ajay Puri [1].

Asia Pacific Musculoskeletal Tumor Society Conference 2018

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Denosumab Therapy Related Changes in Giant cell Tumor (Osteoclastoma) of Bone : A New Osteosarcoma Mimicker

Authors: Pradnya Manglekar [1], Sujit Joshi [1], Yogesh Panchwagh [1].

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Author: Ajay Puri [1].

Asia Pacific Musculoskeletal Tumor Society Conference 2018

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Authors: Pradnya Manglekar [1], Sujit Joshi [1], Yogesh Panchwagh [1].

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Journal of Bone and Soft Tissue Tumors (JBST) Editorial Office

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