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New Agents for the Management of Tenosynovial Giant Cell Tumor:
A Virtual Reality Tour of CSF1 Pathway Inhibitors
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A 37-year-old patient with diffuse-type TGCT recently underwent arthroscopic synovectomy of her knee and she would like to know her prognosis. Which of the following statements is TRUE?
Surgical resection of diffuse-type TGCT is usually curative.
The patient will likely see significant improvements in range of motion and decreased joint stiffness with surgical resection.
Many patients with diffuse-type TGCT experience disease recurrence and may require multiple disabling surgeries.
Similar outcomes are observed in patients with diffuse-type TGCT who receive collaborative care in a specialized sarcoma center versus those who do not.
Which of the following statements best describes the role of colony-stimulating factor 1 (CSF1) in the pathogenesis of TGCT?
Neoplastic cell proliferation is induced by CSF1 overexpression.
CSF1 is overexpressed by immune cells in diffuse-type TGCT.
The tumor is largely composed of immune cells attracted by the overexpression of CSF1 from neoplastic cells.
CSF1 overexpression is the result of a single mutation in chromosome 14.
A 50-year-old man presents with recurrent diffuse-type TGCT in his left knee. He underwent arthroscopic anterior synovectomy in 2016 and an open synovectomy followed by radiation in 2018. The patient has significant swelling and pain in his knee, and he has used a wheelchair for the last 18 months. Which of the following would be the best option to manage this patient’s TGCT?
Imatinib
Emactuzumab
Pexidartinib
Adalimumab
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