Arpornchayanon Olarn, Leerapun Taninnit, Sivasomboon Chate, Settakorn Jongkolnee, Sugandhavesa Nantawit, Pruksakorn Dumnoensun
Musculoskeletal Oncology Division, Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Suthep Road, Chiang Mai TH-50200, Thailand.
J Med Case Rep. 2011 Mar 7;5:93. doi: 10.1186/1752-1947-5-93.
Intra-cortical osteosarcoma is the rarest subtype of osseous-producing tumor. Most reported cases present a low-grade histology with slow progression and good oncological control after adequate treatment. In this report, we describe a case and review the literature to propose adequate treatment.
We present the case of a 21-year-old Thai woman who was thought to have an intra-cortical osteosarcoma of the right tibia. We performed a wide resection and reconstruction with bone transportation using an Ilizarov external fixator. The tumor recurred five years later at the same site with a similar histology. We performed a new resection and reconstruction by ankle arthrodesis with adjuvant chemotherapy. At the last follow-up, she had remained active and free from disease for seven years.
This case report of recurrent intra-cortical osteosarcoma describes an atypical presentation. The low-grade histology, adequate surgical margin and adjuvant chemotherapy of the recurrent lesion were favorable factors, and our patient has remained free of any tumor recurrence.
皮质内骨肉瘤是骨生成性肿瘤中最罕见的亚型。大多数报道的病例组织学分级较低,进展缓慢,经过充分治疗后肿瘤学控制良好。在本报告中,我们描述了一例病例并回顾文献以提出适当的治疗方法。
我们报告一例21岁泰国女性,被诊断为右胫骨皮质内骨肉瘤。我们采用Ilizarov外固定架进行了广泛切除并通过骨搬运进行重建。五年后肿瘤在同一部位复发,组织学表现相似。我们通过踝关节融合术并辅助化疗进行了新的切除和重建。在最后一次随访时,她保持活跃状态,且已无病生存七年。
本复发性皮质内骨肉瘤病例报告描述了一种非典型表现。复发病变的低级别组织学、足够的手术切缘和辅助化疗是有利因素,我们的患者未出现任何肿瘤复发。