scholarly journals Saving a Child’s Elbow Joint: A Novel Reconstruction for a Tumour of the Distal Humerus

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Calogero Graci ◽  
Czar Louie Gaston ◽  
Robert Grimer ◽  
Lee Jeys ◽  
Korhan Ozkan
Keyword(s):  
Distal Humerus ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Wide Resection ◽  
Parosteal Osteosarcoma ◽  
En Bloc ◽  
Fibular Autograft ◽  
Excellent Functional Result ◽  
Extracorporeal Irradiation ◽  
Inexpensive Technique

Reconstruction after wide resection of a malignant bone tumor can be obtained using several techniques such as the use of prostheses, allograft, autograft, or combined procedure. We describe a 12-year-old girl with parosteal osteosarcoma of the distal right humerus treated by en bloc resection, intraoperative extracorporeal irradiation, and implantation. We inserted a nonvascularised fibular autograft through the middle of irradiated graft to obtain a greater stability. We have not recorded any complication associated with this technique such as nonunion, pathological fracture, infection, and bone necrosis and we obtained an excellent functional result. 10 years after surgery, the patient had no recurrence. Extracorporeal irradiation and reimplantation is a valid and inexpensive technique for the treatment of bone tumors when there is reasonable residual bone stock. With this procedure we have a precise fit being the patient’s own bone. In this way we avoid all the problems related to the adaptation of the shape and size.

Parosteal Osteosarcoma of the Fourth Metatarsal Bone

Foot & Ankle ◽  
1982 ◽  
Vol 3 (1) ◽  
pp. 50-52 ◽  
Author(s):  
Michael E. Kliman ◽  
Victor L. Fornasier ◽  
David E. Hastings
Keyword(s):  
Foreign Body Reaction ◽  
Functional Result ◽  
Bone Destruction ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Metatarsal Bone ◽  
Parosteal Osteosarcoma ◽  
New Bone Formation ◽  
En Bloc ◽  
Excellent Functional Result

The authors present a case of a parosteal osteosarcoma of the fourth metatarsal in a 19-year-old male. This location has never been previously reported. The periosteal new bone formation without bone destruction must be differentiated from foreign body reaction and stress fractures. En bloc resection of the fourth and fifth rays was done. There has been no evidence of recurrence to date, 1 year and 10 months following the surgery. There has been an excellent functional result.

scholarly journals Giant Cell Tumor of Distal Radius: En Bloc Resection and Partial Wrist Arthrodesis Using Non-Vascularized Fibular Autograft

2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Davod Jafari ◽  
Hooman Shariatzadeh ◽  
Mohammad Ali Okhovatpour ◽  
Mehran Razavipour ◽  
Farshad Safdari
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Distal Radius ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Cell Tumor ◽  
En Bloc ◽  
Wrist Arthrodesis ◽  
Fibular Autograft

scholarly journals Successful en Bloc Resection for Femoral Head Clear Cell Chondrosarcoma Without Biopsy: A Case Report

2021 ◽  
Author(s):  
Manabu Hoshi ◽  
Naoto Oebisu ◽  
Yoichi Ohta ◽  
Ayaka Tomimoto ◽  
Hiroaki Nakamura
Keyword(s):  
Femoral Head ◽  
Clear Cell ◽  
Surgical Margin ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Wide Resection ◽  
Low Grade ◽  
En Bloc ◽  
Postoperative Function ◽  
Clear Cell Chondrosarcoma

Abstract Background: Clear cell chondrosarcoma (CCCS) is a rare, low-grade, malignant chondrogenic bone tumour. This tumour commonly occurs at the epiphysis of long bones, particularly in the proximal femur. Case presentation: This report describes a 58-year-old man with right hip pain since 5 months. Plain radiography, magnetic resonance imaging (MRI), and computed tomography (CT) revealed the characteristic appearance of chondroid mineralisation in the right femoral head, suggesting typical CCCS. Although a biopsy is the gold standard for definite diagnosis before treatment, wide resection with removal of the biopsy tract is thought to affect negatively affect surgical margin and postoperative hip function. En bloc resection without a biopsy and a hip hemiarthroplasty were performed instead. The pathological diagnosis was CCCS, and an adequate surgical margin was obtained. No local recurrence or distant metastases were found, and postoperative function was excellent at the final follow-up. Conclusion: The femoral head is a typical location of CCCS. Wide resection with adequate margins is the main treatment strategy for CCCS. When radiological features are typical, performing an en bloc resection without performing a biopsy is an acceptable treatment that may improve patient outcomes.

Partial Sacrectomy for Resection of a Sacral Chordoma: 2-Dimensional Operative Video

2020 ◽  
Vol 19 (4) ◽  
pp. E412-E412
Author(s):  
Martin Julian Gagliardi ◽  
Alfredo Guiroy ◽  
Alfredo Sícoli ◽  
Nicolás Gonzalez Masanés ◽  
Alejandro Morales Ciancio
Keyword(s):  
Osteolytic Lesion ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Wide Resection ◽  
Resection Margins ◽  
Low Grade ◽  
En Bloc ◽  
Ct Guided ◽  
Sacral Chordoma ◽  
Sacrococcygeal Region

Abstract Sacral chordomas are infrequent tumors that arise from remnants of the notochord. They are most often found in the sacrum and skull-base.1,2 These lesions rarely metastasize and usually have an indolent and oligosymptomatic clinical course. Chordomas show low sensitivity to standard radiation therapy and chemotherapy. Operative resection with wide resection margins offers the best long-term prognosis, including longer survival and local control.1,3 However, achieving a complete resection with oncological margins may be difficult because of the anatomic complexity of the sacrococcygeal region.4 The main complications of sacral resection include infections, wound closure defects, and anorectal and urogenital dysfunction. The rate of these complications is significantly increased when the tumor involves the S2 level or above. We report the case of a 64-yr-old male who presented with progressive sacrococcygeal pain and a feeling of incomplete evacuation. A heterogeneous, osteolytic lesion was found at the sacrococcygeal region. Full body imaging tests were negative for other lesions. A computed tomography (CT) guided biopsy was made. We usually use the midline approach in case we have to include the needle path in the resection. The pathology confirmed a sacrococcygeal, low-grade chordoma. We decided to perform an en bloc resection. A posterior, partial sacrectomy was planned distal to the S4 level.

En bloc resection, extracorporeal irradiation, and reimplantation of an entire tibia

2006 ◽  
Vol 11 (3) ◽  
pp. 298-302 ◽  
Author(s):  
Shinobu Takahashi ◽  
Shuzo Okudaira ◽  
Keisuke Sasai ◽  
Yoshihiko Kotoura
Keyword(s):  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Extracorporeal Irradiation

scholarly journals Single stage en bloc resection of a recurrent metastatic osteosarcoma of the pediatric lumbar spine through multiple exposures – a novel approach

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 32
Author(s):  
Saurabh Gupta ◽  
Zachary S. Stinson ◽  
Rex A. Marco ◽  
John P. Dormans
Keyword(s):  
Surgical Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Single Stage ◽  
Neurological Deficits ◽  
Wide Resection ◽  
En Bloc ◽  
Novel Approach ◽  
Metastatic Osteosarcoma

To obtain a wide resection and safe margins in recurrent spine osteosarcoma, the surgical approach can include – posterior only, combined posterior and anterior, and combined posterior and anterior with a return to posterior in multiple stages. In our case, we used a novel approach of multiple extensile exposures circumferentially in a single stage with a single surgical prep. We present the case of a 9-year-old female with a history of metastatic osteosarcoma, who previously underwent an attempted en bloc resection with an L3 corpectomy and left below knee amputation. At 1 year follow-up, she developed a recurrent solitary spine lesion at the previous surgical resection site. An additional attempt at complete surgical resection was performed with a complex en bloc L2, L3, L4 corpectomy with removal of deep spinal implants and anterior and posterior spinal fusion with instrumentation and revision decompressive laminectomy. The patient had a good functional outcome without neurological deficits, except those resulting from resection of involved lumbar nerve roots. At last follow-up of 5 months, there was no local recurrence or distant metastasis. This approach for revision resection of recurrent spinal osteosarcoma can be performed successfully with clean margins in a safe manner.

scholarly journals Effect of extracorporeal irradiation on segmental bone autograft incorporation in Sprague-Dawley rats

2014 ◽  
Vol 23 (3) ◽  
pp. 147-53 ◽  
Author(s):  
Muhammad Wahyudi ◽  
Achmad F. Kamal ◽  
Nurjati C. Siregar ◽  
Marcel Prasetyo
Keyword(s):  
En Bloc Resection ◽  
Bloc Resection ◽  
Control Group ◽  
Sprague Dawley ◽  
Negative Effects ◽  
En Bloc ◽  
Sprague Dawley Rats ◽  
Segmental Bone ◽  
Bone Autograft ◽  
Extracorporeal Irradiation

Background: Bone graft has been widely used in bone tumor reconstructive surgery. Extracorporeal irradiation (ECI) is commonly used to eliminate malignant cells before bone autograft. However, it may have negative effects on autograft incorporation. This study aimed to evaluate the ability of bone autograft incorporation after extra corporeal irradiation.Methods: 24 Sprague-Dawley rats underwent 7-mm en bloc resection of tibial diaphysis, and were divided into 4 groups. The first group did not receive irradiation; the 2nd, 3rd, and 4th groups received 50, 150 and 300 Gy bone irradiation respectively, and then reimplanted. Radiologic score were evaluated at week-6 and -8, while histopathology, osteoblast count and BMP-2 expression were examined at week-8. Data were analyzed with ANOVA or Kruskal-Wallis tests.Results: At week-6, radiologic scores in group 150 and 300 Gy were significantly lower compared to control group (4 vs 6 dan 4 vs 6; p = 0.011; p = 0.01). The same results were also obtained at week-8 (5.40 vs 7.14; p = 0.009 in the group 150 Gy and 5.60 vs 7.14; p = 0.018 in the group 300 Gy. Histopathological scores of the groups receiving 50, 150 and 300 Gy were significantly lower compared to the control group (6 vs 7, p = 0.017; 4 vs 7, p = 0.005; 6 vs 7, p = 0.013). Osteoblast count and BMP-2 expression were not significantly different among all groups.Conclusion: ECI with the dose of 50 to 300 Gy is associated with delayed bone autograft incorporation. However, the osteoinductive and osteogenesis capacity for autograft incorporation were maintained.

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