[En-bloc resection with immediate reconstruction of malignant tumor of the humerus--report of 9 patients].

From March 1966 to June 1985, 9 patients with humerus malignant tumor were treated by en-bloc resection and immediate reconstruction. There were 5 males and 4 females. The ages ranged from 18 to 74 with an average of 38.3 years. These 9 lesions were diagnosed by pathology as malignant giant cell tumor of the bone (2), chondrosarcoma (2), reticulum cell sarcoma (1), osteoblastoma (osteosarcomatous) (1), osteogenic sarcoma (1) and metastatic cancer (1) clear cell cancer and 1 thyroid cancer), located either in the upper or lower end of the humerus. Cutting margin was 4-7 cm from the tumor. The length of resected humerus was 10-18 cm. Simple excision without reconstruction was done only in 1 patient. The bone defect after resection was reconstructed with autogenous fibular graft in 3 patients, replantation of the limb in 2, one of whom was added with prosthesis for reconstruction of the elbow function, humerus prosthesis in 2 and elbow prosthesis in 1. All the patients were followed. Only two had died and 7 are still alive without evidence of disease. The longest survival was 20.5 years and the shortest, 18 months with an average of 10.1 years. The causes of death (1 osteoblastoma and 1 osteogenic sarcoma) were recurrence and lung metastasis. The indication, extent of excision and causes of recurrence are discussed.