Chinder Pramod, Hindiskere Suraj, Doddarangappa Srinath, Pal Utkarsh, Daggupati Kiran Tej
Department of Musculoskeletal Oncology, HCG Hospital, Bengaluru, India.
Department of Orthopaedics, M S Ramaiah Medical College, Bangalore, India.
J Orthop Case Rep. 2019 Jan-Feb;9(1):58-61. doi: 10.13107/jocr.2250-0685.1308.
Ewing's sarcoma (ES) is a malignant tumor of the bone and soft tissue arising from the neuroectodermal cells. It commonly arises from the extremities of children and young adults and very rarely from flat bones like the scapula. Locally advanced disease with prior history of surgery and poor response to neoadjuvant chemotherapy in a bedridden patient is usually treated by forequarter amputation, considering the anatomical complexity of the shoulder girdle.
A young adult diagnosed and previously operated for ES of the left scapula, presented to us with a massive fun gating mass over the left upper back, excruciating pain and inability to use the left upper limb. Limb salvage surgery was performed, followed by adjuvant radiotherapy, chemotherapy, and autologous stem-cell transplantation. The patient is disease free with a functional limb on 3 years of follow-up.
ES of scapula is very rare. With meticulous surgery and multidisciplinary treatment approach, limb salvage can be achieved even in such advanced cases, thereby prolonging survival and providing better quality of life.
尤因肉瘤(ES)是一种起源于神经外胚层细胞的骨与软组织恶性肿瘤。它常见于儿童和青年的四肢,极少发生于像肩胛骨这样的扁骨。对于一名卧床且有手术史、新辅助化疗反应不佳的局部晚期疾病患者,考虑到肩胛带的解剖复杂性,通常采用前半侧截肢术进行治疗。
一名曾因左肩胛骨尤因肉瘤接受诊断及手术的青年成人,前来我院就诊,其左上背部有一个巨大的瘘管性肿物,疼痛难忍,且无法使用左上肢。我们实施了保肢手术,随后进行辅助放疗、化疗及自体干细胞移植。经过3年随访,患者无疾病,肢体功能良好。
肩胛骨尤因肉瘤非常罕见。通过细致的手术及多学科治疗方法,即使在如此晚期的病例中也可实现保肢,从而延长生存期并提供更好的生活质量。