Acta Ortopédica Mexicana

Espejo-Sánchez G, Rico-Martínez G, Linares-González LM, Delgado-Cedillo E, Clara-Altamirano MA
Periacetabular pelvic reconstruction for chondrosarcoma with autograft of the proximal femur
Acta Ortop Mex 2012; 26 (4)

Language: Español
References: 19
Page: 250-254
PDF: 92.94 Kb.

[Fulltext - PDF]

ABSTRACT

Introduction: Chondrosarcoma is a malignant tumor of chondroid matrix-producing cells; based on its frequency, it is the second most common malignant bone tumor (10-20%) and responds poorly to chemo- and radiotherapy. It is infrequent in the pelvis. It has a rapid growth potential. The indicated treatment is broad resection with tumor-free margins. Pelvic reconstruction after resection is controversial. The current management of musculoskeletal neoplasias has a two-fold purpose. First of all, controlling the neoplasia by means of surgeries with cancer-free margins and, second, performing procedures for the reconstruction of the involved segment achieving limb preservation with maximum functionality. Objective: Intrapelvic reconstruction with the proximal third of the ipsilateral femur in a patient with a chondrosarcoma in Enneking-Dunham’s zone II. And placement of an unconventional femur prosthesis. Clinical case: We present herein the case of a 58 year-old male, with a lytic lesion of the right acetabulum. The patient completed the diagnostic protocol, and the biopsy result was dedifferentiated chondrosarcoma. Conclusion: The purpose of the surgical technique is to use the proximal third of the femur as a novel reconstruction alternative with massive autograft for tumor lesions located in Enneking-Dunham zone II.


Key words: pelvis, neoplasm, graft, femur, treatment, reconstruction, surgical technique.


REFERENCES

  1. Fletcher C, Unni KK, Mertens F, editors: Phatology and genetics of tumors of soft tissue and bone. Lyon, France: IARCPress: 2002.

  2. Rico MG, Linares GL, Delgado CE: Experiencia de cinco años en el tratamiento del condrosarcoma, Instituto Nacional de Rehabilitación. Rev Mex Ortop Trauma 2002; 16(2): 55-61.

  3. Dahlin Dc, Beabout JW: Defferentiation of low grade chondrosarcomas. Cancer 1971; 28: 461-6.

  4. Giunti A, Campanacci M: Dedifferentiation chondrosarcoma. J Bone Joint Surg Am 1988; 70A: 60-9.

  5. Simon MA: Current Concepts Review : Biopsy of Musculoskeletal Tumors. J Bone Joint Surg Am 1982; 64: 1253-7.

  6. Casas-Ganem J, Healey HJ: Advances that are changing the diagnosis and treatment of malignant bone tumors. Curr Opin Rheumatol 2005; 17: 79-85.

  7. Domb GB, Tyler W, Ellis S, McCarthy E: Radiographic evaluation of pathological bone lesions: current spectrum of disease and approach to diagnosis. J Bone Joint Surg Am 2004; 86: 84-90.

  8. Rico MG, Linares GL, Miranda JA: Hemipelvectomía parcial interna por condrosarcoma secundario gigante de pelvis, reporte de caso. Act Ortop Mex 2007; 21(4): 189-93.

  9. Ahmed AR: secondary chondrosarcoma in osteochondroma: report of 107 patients. Clin Orthop. 2003; 411: 193-206.

  10. Chao EY, Ivins JC: Tumor prosthesis for bone and joint reconstruction. Stuttgart-Nueva York: Thieme-Stratton; 1983.

  11. Friedlaender GE: Current concepts review bone banking. J Bone Joint Surg Am 1982; 64(A): 307-11.

  12. Dion N, Sim FH: The use of allografts in musculoskeletal oncology. J Bone Joint Surg Am 2002; 84 A: 644-54.

  13. You-Shui Gao, Jiong Mei, Chang-Qing Zhang: To reconstruct the hemipelvis and acetabulum with homolateral proximal femur: a feasible way for hip reconstruction after tumorectomy involving the ace­tabulum. Europ J Orthop Surg Trauma 2001; 21(3): 145-9.

  14. Lee FY, Mankin HJ, Fondren G, et al: Chondrosarcoma of bone: An assessment of outcome. J Bone Joint Surg Am 1999; 81A: 326-38.

  15. Sugar Baker Pavl, Malawer M: Cirugía del cáncer musculoesquelético. Principios y técnicas. Madrid: Mosby Doyma; 1995: 150, 163, 193, 195.

  16. Campanaci M, Capanna R: Pelvic resections: the Rizzoli Institute experience. Orthop Clin North Am 1991; 22(1): 65-86.

  17. De Vita TV, Sanvel H: Principios y tratamiento del Cáncer. Philadelphia, Pa: Lippincott Williams & Wilkins; 1997: 741-2.

  18. Kim JH, Hahn EW: Clinical and Biological studies of localized Hyperthermia Departamento de Radioterapia, Memorial Sloan Ketterin Center, New York. Cancer Research 39, 2258-61.

  19. Sánchez-Torres LJ, Santos-Hernández M, Carmona-Rendón R: Neoplasias malignas en pelvis y su resección. Centro Médico del Noreste. IMSS. Act Ortop Mex 2009; 23(4): 237-42.