臨床整形外科49巻3号

2014年03月発行

誌上シンポジウム 良性腫瘍に対する最新の治療戦略

骨巨細胞腫

著者： 武内章彦¹ 土屋弘行¹

所属機関： ¹金沢大学大学院医薬保健学総合研究科・医薬保健学域医学類機能再建学（整形外科学）講座

ページ範囲：P.233 - P.241

　骨巨細胞腫(giant cell tumor，以下GCT)は，若年～中高年の膝関節周囲に好発する良性骨腫瘍であるが，骨盤や脊椎など手術が困難な部位にも発生する．良性骨腫瘍ではあるが，局所浸潤性が強く，再発率が高く，また時に肺転移や悪性転化を来す可能性がある．治療の基本は，徹底的な掻爬と種々の補助療法を組み合わせた手術療法であるが，関節を含めた広範切除や手術が困難な部位では動脈塞栓術など，腫瘍の発生部位や進展の程度などにより腫瘍の根治性と機能を考慮して治療方法を選択する必要がある．さらに近年は，破骨細胞分化促進であるRANKL(receptor activator of NF-κB Ligand：NF-κB活性化受容体リガンド)に対する抗体(デノスマブ)を用いた新たな薬物療法が試みられつつある．本稿では，GCTの病態生理から手術療法，最新の薬物療法などについて文献的考察を加えて述べる．

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