Operative management of chondrosarcoma in pelvic region: case series

Chondrosarcoma is the second most frequent malignant bone tumour after osteosarcoma. It most often occurs in the pelvis. Treatment of pelvic chondrosarcoma is a difficult problem for the musculoskeletal oncologist. We report 3 patient with chondrosarcoma in pelvic region that undergoing internal hemipelvectomy. First patient, male 28 y.o. with chondrosarcoma in left iliac wing 11.2cm x 10.8cm x 9.2cm. Second, woman, 47 y.o with chondrosarcoma in right superior and inferior pubic rami 13.7cm x 11.5cm x 14.2cm with soft tissue mass around extended to medial part of proximal thigh. Already done A wide excision of the tumor was performed and we use non-vascularized fibular graft (NVFG) to fill the defect. Last patient, pregnant woman 22 y.o. (16weeks gestational age) with chondrosarcoma in right pubic rami 9.8cm x 11.4cm x 13cm. We already done internal hemipelvectomy without terminating the fetus. The second and third patient confirmed with the histopathology result with chondrosarcoma grade II, and the first patient with chondrosarcoma grade I. After 3month post operatively, all of the patients have no pain, no urinary tract complain. The first patient can ambulatory full weight bearing with no crutches or walker. Second patient ambulatory partial weight bearing with crutches. The last patient ambulatory with wheel chair during the pregnancy. Since chondrosarcomas are unresponsive to chemotherapy or radiotherapy, surgical resection was the only therapeutic solution for these patients. It also reinforce the need of a correct diagnose and collaboration between specialities in the treatment of oncological patients

Proximal Tibial Osteosarcoma in Pediatric Patient: A Case Report

Background: The most frequent primary malignant bone tumor in children is osteosarcoma. Patients with osteosarcoma are currently treated with a combination of neoadjuvant and adjuvant chemotherapy as well as surgery, either limb-sparing surgery or limb-ablation surgery. How to manage the remaining bone growth during the limb-sparing procedure in youngsters is one of the challenges. Unfortunately, amputation is still many perform for OS patients. The purpose of this study was to inform and educate doctors about the value of early OS diagnosis and treatment in pediatric patients.Case Presentation: We presented case from a male 16 years old Balinese complaint of pain on her left knee 12 months ago. The pain was continuous and got worse at night. The patient went to a traditional masseuse and was given topical herbal ointment. Three months later, a lump appeared on her knee at the size of a small ball and getting bigger. We did a review slide of the previous biopsy sample by the pathology of anatomy in our hospital. The result came out as osteosarcoma with osteoblastic cells. We performed to amputated the limb-affected tumor following wound care routinely controlled.Results: Intraoperatively, we performed wide excision, without patellar tendon, medial collateral ligament, and cruciate ligament preserve. We amputated the limb-affected tumor. The patient routinely controlled to our outpatient clinic every week. Unfortunately, the patient was died after 3 weeks of admission.Conclusion: To reduce the risk of misdiagnosis or delayed diagnosis of osteosarcoma, every source of knee pain with a mass in pediatric age groups should be thoroughly explored with a high index of suspicion for malignant lesions. Therefore, amputation is a cutting-edge osteosarcoma treatment that can be avoided if the patient can be identified early and treated quickly in pediatric oncology malignant instances.Keywords: osteosarcoma, long bone, diagnosis, tibia, pediatricCorrespondence: Komang Septian Sandiwidayat. Oncology Division, Department of Orthopaedic & Traumatology, Sanglah General Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia. Email: [email protected]. Mobile: 62-821-4725-2042.Indonesian Journal of Medicine (2022), 07(03): 298-305https://doi.org/10.26911/theijmed.2022.07.03.06